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Journal of the Anatomical Society of India

Abstract of papers presented during the 54th National Conference of The Anatomical Society of India, 2006 held at Amrita Medical College, Kochi, Kerala (56 - 99)

Author(s): Editors

Vol. 56, No. 1 (2007-01 - 2007-06)

56. Internal Carotid Artery Segmentation

A.Prasanna Veera Kumar and K.S.N.Prasad

Siddhartha Medical College, Vijayawada.

In the dissection of brain it was observed that the posterior communicating artery was arising from anterior choroidal artery and after joining with the posterior cerebral artery (PCA), the posterior cerebral artery was dividing into slender branches.

The missing segment as per Philippe Gailloud et al was located between the posterior communicating artery (PCoA) and the anterior choroidal artery which is a prominent branch in the embryo. According to them the PCoAis no longer derived from caudal division of the ICAbut simply as another embryonic vessel bridging the anterior and posterior cerebral circulation. The caudal ICAdivision is classically viewed as being the origin of posterior cerebral artery, its proximal portion becoming the PCoA once the distal connection with the basilar artery is established. This concept has been challenged by the study of Van Overbeeke and according to them PCoA artery is a bridging channel that either regresses into a small or absent PCoAor stays prominent as a so-called fetal origin of PCA. As per Philippe Gailloud et al their definition of 8th embryonic segment was in accordance of the PCoA as being the most cranial basilar anastomosis .In the present study the origin of PCoA from anterior choroidal artery can be said as embryonic vessel bridging the anterior and posterior cerebral circulation.

57. Cavum Septi Pellucidi (CSP)

SS Jothi, DS Lekha, D Saisucheehra, BTN Rao and TSG Priya

Katuri Medical College and Hospital, Guntur.

Presence of cavum septi pellucidum in one out of 165 brains studied made us look in the details of this condition.

One brain out of 165 brains dissected so far during 33 years of routine dissection showed the presence of CSP.

Normally the septum pellucidum is attached to the medial margin of corpus callosum. Here in this specimen it was attached to the lateral margin of corpus callosum. It was seen extending from the anterior end of the corpus callosum (Genu) to the posterior end of corpus callosum (Splenium) measuring 5 cms in length.Cavity of the lateral ventricle was not narrowed by this CSP.

CSP is formed, if fetal S.P fails to obliterate.

Present in 100% of premature, 85% term infantsand 120% of adults. In our observation one out of 165 brain dissected brains showed the presence of this cavum septi pellucidi.

This condition may be associated with Hydrocephalus and Schizophrenia. In this case there was no hydrocephalus and it was not associated with any other structural anomaly.

The fact that, this brain with large CSP belongs to an elderly female shows that, with out much complication the person must have lived up to this age.

58. Cervical Rib And Sacralization Of Lumbar Vertebra

TS Gugapriya, Padmavathy, N Rajasekar, and S S Jothi

Katuri Medical College and Hospital, Guntur.

To determine the association between presence of cervical rib and sacralization of lumbar vertebrae.

Plain A-P radiographs of cervical and lumbo-sacral region of 5 patients who presented with symptoms of thoracic outlet syndrome or low back pain over a period of 6 months to our out patient clinic were taken for the study.

Of the 5 cases, 4 patients who presented with thoracic outlet syndrome were found to have bilateral cervical rib ranging from incomplete to complete. In the same patients the lumbo-sacral region x-ray showed sacralization of 5th lumbar vertebrae. The other patient who presented with low back pain was found to have a sacralization. X-ray cervical region was taken for this patient who presented with bilateral incomplete cervical rib. Incidentally in all these patients the 12th rib was found to be absent.

Presence of cervical rib in a patient might be a clue to the existence of sacralization and vice versa. In a patient with cervical or lumbar pain this association may be helpful for differential diagnosis before applying sophisticated diagnostic techniques.

59. Extensor Carpi Radialis Tertius – A Rare Case Report

SR Nayak,Madhan KSJ, Ashwin K and Latha VP

Kasturba Medical College, Mangalore.

The knowledge of anatomical variations in the antebrachial and dorsal regions of the arm and hand are useful in hand surgery. The extensor carpi radialis intermedius (ECRI) and extensor carpi radialis accessorius (ECRA) are two classic variants described for the radial wrist extensors, in the antebrachial region. We report an additional extensor carpi radialis muscle taking origin from the common extensor origin, between the extensor carpi radialis longus (ECRL) and extensor digitorum communis (EDC). The tendon of the variant muscle splits below the abductor pollicis longus (APL) and get attached to the base of the second and third metacarpal bone. Due to its considerable size and independent origin from the lateral epicondyle, we suggest the present variation should be named as extensor carpi radialis tertius (ECRT). The clinical significance of the present variation will be discussed.

60. Measurement Of Acetabular Tilt In Human Hip Bones

Joshi SD, Joshi SS, Waghmode PS, Daimi SR and Siddiqui AU

RMC, PIMS, Loni Maharashtra

It is a well known fact, that with the assumption of erect posture, human body has undergone a number of important changes. Some of them are too obvious and can be easily appreciated ; yet there are others which are quite subtle and have an important bearing on human posture, weight transmission and locomotion.

Kapandji (1995) and Timothy (1998) have shown that the acetabular cavity faces laterally, inferiorly and anteriorly.

We have undertaken a study of measurement of 160 hip bones (Rt = 74, Left = 86) and keeping the bones in normal anatomical position, the measurements were made on a specially designed goniometer. Forward tilt of acetabulum was found to be more in females (45°) compared to males (41.35°); whereas downward tilt of acetabulum was more in males (29.63°) as compared to females (26.62°). In both sexes forward tilt of acetabular was greater on the left side. Downward tilt was found to be more on the left side for males and on the right for females. The present findings and their significance will be discussed in the light of available literature.

61. Inherent Torsion Of Hip Bone

Joshi SD, Joshi SS, Waghmode PS, Daimi SRand Siddiqui AU

RMC, PIMS, Loni Maharashtra

Pelvis forms an osteocartilaginous ring and a coronal plane through the acetabulum divides it into anterior and posterior arches. The posterior arch serves for transfer of weight and the anterior arch as a tiebeam preventing separation of posterior arch and acting as a compression strut.

A cursory look at the hip bone confirms that there is a definite twist in the hip bone between upper and lower segments at the acetabulum. As we did not come across any mention of this angle of torsion in the Indian bones we carried out the measurements of this angle in 160 hip bones (Rt-74; Lt -86) with the help of a modified protractor. In our series, this angle of torsion was found to be 650 for females. These findings and their relevance to the mechanics of pelvis will be discussed.

62. Relationship Of Articular To Non-Articular Areas Of Acetabulum And Its Evolutionary Significance

Joshi SD, Joshi SS, Waghmode PS, Daimi SRand Siddiqui AU and Jadhav SD

Rural Medical College, Loni, Maharashtra

With the assumption of erect posture, there have been many changes in the morphology of hip bone. The deep acetabular socket bears a semilunar articular facet and its rim is deficient inferiorly. Its central part is formed by thin cortical bone which is non articular. During development there is presence of tri-radiate-cartilage which allows a change in congruency of acetabulum with the changing femoral head size during growth (Reid, 1992).

For this study 160 hip bones (Rt -74; Lt -86) were utilized. The articular and non articular areas were mapped out separately on tracing paper and the surface area of each measured with the help of digital planimeter.

In the females, both the articular and the non articular parts of the acetabulum were found to be considerably less than in the males. The values for the articular and non articular parts of acetabulum in the males was 23.36 cm2 and

10.16 cm2 respectively and the corresponding figures for the females are 16.01 cm2 and 8.73 cm2. The findings shall be discussed in the light of available literature.

63. Measurement Of Surface Areas Of Various Articular Facets Of Hip Bone And Their Significance

Joshi SD, Joshi SS, Waghmode PS, Daimi SRand Siddiqui AU and Jadhav SD

Rural Medical College, Loni, Maharashtra

The articular areas play a very important role in transmission of various forces including compression and reactionary forces, and also in the movements. Pal (1989) studied the weight transmission in sacrum and calculated the various articular surface areas and found a significantly high correlation between iliac and vertebral articular areas of sacrum. The tracings of various articular areas were made on the tracing paper and the surface area in cm2 was measured by Digital Planimeter.

In the males, distinctly higher values of surface areas were found for all the articular areas measured. Articular surface area of ilium was 10.41 cm2 in males and 9.27 cm2 in females. The symphysial articular surface in the males was 2.87cm2 and in females 2.60cm2. Acetabular semilunar articular surface in the males was found to be

23.36 cm2 whereas in females it was only 16.01 cm2.

A correlation between the various findings and their significance will be presented.

64. Weight Bearing Line In The Acetabulum And Its Evolutionary Significance

Joshi SD, Joshi SS, Waghmode PS, Daimi SR and Siddiqui AU

Rural Medical College, Loni, Maharashtra

During evolution from pronograde to orthograde posture, the lower limbs begin to carry the total weight of the body, and the widest part of articular surface of acetabulum lies at a place where the head of femur is in maximum contact with it during erect posture i.e. upper segment. This region shows general hypertrophy. In quadrupeds ‘weightcum-thrust’ line passes through the ischial part of acetabulum. The head of femur remains in contact with iliac part of acetabulum and its angle with ilium varies considerably from individual to individual. The individuals having smaller angle are supposed to be more evolutionarily advanced than those having posterior shift.

We have undertaken this study to re-evaluate this angle in the hip bones available in department. The angle was more on the right side in both the sexes. Maximum angle was found on right side in male (32.38°) and the lowest value was seen on the left side in the female hip bones (23.43°).

The significance of these findings will be discussed.

65. Some Variations In The Formation Of Brachial Plexus In Human Foetuses

S. Ratnasamy

PIMS, Pondicherry.

The anatomical variations in the formation of brachial plexus are common. But knowing about these variations is of great value, for the surgeons while performing operations in axilla. Fifty brachial plexuses were dissected on spontaneously aborted 25 foetuses without any detectable malformations of various periods of gestation and sex. In one specimen, the lateral root of median nerve was absent (2%) and the musculocutaneous nerve carrying C 5, 6 and7 fibres joined with the medial root of median nerve in the arm. In the same specimen, there was oblique connection from the medial root of median nerve to the musculocutaneous nerve in the axilla. In another specimen, musculocutaneous nerve joined with median nerve distal to coracobrachialis(2%). The intercostobrachial nerve received contribution not only from 2nd and 3rd thoracic spinal nerves but also from 4th and 5th thoracic spinal nerves in one specimen (2%). Asound knowledge about these anatomical variations in brachial plexus is important for the surgeons who perform surgical procedures in the neck, axilla and in the upper arm like radical neck dissections and in repairing the brachial plexus injury due to trauma.

Foetal Brachial Plexus, Musculocutaneous nerve, Median nerve, Intercosto brachial nerve.

66.”The Morphological And Histological Variations In The Appendix From Human To Herbivores And Carnivores Mammals”

Verma PK and Alam.K

Patna Medical College, Patna.

The aim of the experiment is to know, whether the morphological and histological structure of appendix varies in herbivores, carnivores and omnivores (man).

The appendix or caecal-apex were colleced from humans, dogs, rabbits and guineapigs. They were studied morphologically and histologically. In case of man and rabbits, vermiform appendix was taken out for study whereas in guinea pigs and dogs caecal-apex was studied, which is the homologue of the appendix of man and rabbit.

The caecum and associated, appendix are. important sites for the digestion of cellulose. The largest caecum and appendix was found in the rabbits which is a herbivore. Herbivores have larger appendix than carnivores or omnivores. Morphological study regarding shape, size and presence or absence of mesentry was undertaken.

Histological variations were observed with regard to goblet cells and lymphoid tissues.

Thus we see that food habits show variations in morphology and histology of the appendix.

67. Unilateral Hydroureter With Right Sided Hydronephrosis

Sumathi S and SD Desai.

BMPMCHandR, Bijapur

Analyzing the abnormalities during regular cadaveric dissection in our department

During cadaveric dissection, a monoblock dissection of male adult urogenital system was done. The organs were examined.

The prostate was hard and mildly enlarged in shape and size. There was a hard nodule like growth of 1×1 cm partially obstructing the prostatic part of the urethra from the median lobe

Both the kidneys were normal in shape and size. On sectioning the kidneys, the right kidney showed mild dilatation of the calyces. The left kidney was normal. The right ureter was dilated. Maximum dilatation was at the 2nd part of the ureter measuring 1.5 cms. The left ureter was normal

The urinary bladder was enlarged. When the bladder was opened, no vesicle stone was found

The causes and pathophysiology of enlarged prostate and urinary bladder producing hydronephrosis and hydroureter were analysed.

68. Iliofemoral Arterial Malformation

Varsha N, Mangala MP and Latha VP

KMC, Mangalore, Karnataka

During routine dissection, an iliofemoral arterial malformation was noticed in a 65 year old male cadaver. The abdominal aorta was considerably laterally displaced and also bifurcated higher up. The common iliac artery divided one vertebral level higher and the femoral artery gave the profunda femoris artery about 1.2 cm below the inguinal ligament, which is considerably proximal to its usual level of origin. A brief review of literature and embryological basis of the anomalies are discussed.

69. Anomalous Termination Of The Facial Vein

Mangala MP, Rajanigandha V and Latha VP

KMC, Mangalore, Karnataka

Anatomic and morphologic variations of the facial vein are of immense importance for surgeons doing reconstructive surgery. In view of this surgical significance, a study was conducted to determine the incidence of variation in the termination of the facial vein.

52 adult cadavers (104 sides) were dissected to study the drainage pattern of the facial vein.

Eight out of 104 sides (7.7%) showed an anomalous coursing of the facial vein to drain into the external jugular vein. One among these eight variants had a differed anatomical presentation. Knowledge of varying venous pattern is important for surgeons performing head and neck micro vascular surgeries, to avoid unnecessary bleeding during intra operative trial and error procedures.

70. Accessory Brachialis Muscle And Double Lateral Cutaneous Nerve Of Forearm: A Case Report

Merin T, Mangala MP, SR Nayak and Latha VP

KMC, Mangalore, Karnataka

Variations of arm flexors are not uncommon with the exception of brachialis muscle. The role of brachialis is critical as it is the primary flexor of the elbow joint. Variations of brachialis are rare in literature. We present a case of an accessory brachialis muscle (AcBr) found, during routine cadaveric dissection in the department of anatomy, Kasturba Medical College, Mangalore. The AcBr was originating from the lateral aspect of the brachialis muscle and lateral intermuscular septum. During its course towards the elbow, it was crossing over the radial nerve and the distal tendon splits into two. The medial slip was running over the ulnar artery and merged with the deep fascia covering the pronator teres muscle, where as lateral slip was inserting to the fascia covering the supinator. In the ipsilateral arm an additional lateral cutaneous nerve of forearm (Lcnf) was found coursing over the brachialis muscle medial to the Lcnf. Clinical consideration of the present variations will be discussed.

71. A Case Report Of Complete Situs Inversus

Manimay B, R Singh and Jayanti B

CNMC, Kolkata

A 45 year male while being dissected during undergraduate teaching was discovered as a case of complete situs inversus, a rare congenital abnormality. The thorax and the abdomen dissection revealed a complete mirror image of the normal visceral arrangement. The heart possessed an atrial septal defect. The abdomen revealed enlarged spleen, liver and gall bladder .The gall bladder was full of stones, with stones present in the common bile duct, too. The left kidney had an accessory renal artery supplying it. Our aim is to describe the anatomic relations of the visceras in the situs inversus, so as to decrease the incidence of the mishappenings in the clinical practice and to correlate the anomaly embryologically, which in this case seems to be due to the defect in the lateralization.

72. Placental Co-Efficient As Indicator Of Intrauterine Growth Retardation: A Case-Control Study

S Biswas, JC Chattopadhyay and SK Ghosh

MGIMS, Sewagram.

Placentae from fifty (50) full-term, uncomplicated deliveries were collected between November 2003 to December 2004. Of them, twenty eight (28) were associated with IUGR babies and twenty two (22) were of normal weight babies (controls). The mean fetal weight of IUGR group was 2097.53 gm and that of control group was 2804.27 gm. The placental weights of IUGR group ranged from 180 gm to 458 gm (mean 333.32 gm), whereas those of controls ranged from 340gm to 545 gm (mean 416.77 gm). Placental Co-Efficient (placental weight/ fetal weight) was determined in both the groups. Surprisingly, it was observed that the mean placental co-efficient of IUGR group was significantly greater (p-0.01) than that of control group. Placental coefficient of IUGR group was found to be 0.155 (range 0.11- 0.22) and that of control group was 0.138 (range 0.120.18).

Though both placental and fetal weights were less in IUGR group, relative weight of placentae to the fetuses actually increased. This suggested that there might be changes in haemodynamics and histological features of the placentae resulting in IUGR.

73. Variations In The Configuration Of Circle Of Willis

Kanchan Kapoor, Late Dewan IJ and Singh B

Government Medical College, Chandigarh.

Brains were obtained from one thousand medicolegal autopsy subjects of varying ages. The circle of Willis was examined at the base of the brain. The cerebral vessels were observed with regards to their origin, caliber and normal configuration. Variations were noted and grouped into different categories. Out of 1000 specimens examined, 452 (45.2%) conformed to the normal pattern. In rest of the specimens (54.8%), there were variations in the circulus arteriosus. The circle was deficient in only 32 (3.2%) instances. The anterior cerebral artery was absent in 0.4%; hypoplastic in 1.7%; bifurcated in 2.6%; triple in 2.3% and single in 0.9% specimens. The anterior communicating artery was absent in 1.8%, duplicate in 10%, triplicate in 1.2% and plexiform in 0.4% specimens. Multiplication of posterior cerebral artery was observed in 2.4% cases while it was hypoplastic in 10.6% brains. Posterior communicating artery was absent in 1 % and hypoplastic in 13.2% specimens. 74 (7.4%) brains showed multiple variations. Intracranial saccular aneurysm was present in 10(1%) instances. The above variations are discussed in light of their development and other haemodymanic factors.

74. A Study On The Clinically Relevant Variations Of The Carotid Arterial System

Anu VR, Mangala MP, R Rai and Latha VP

CBS, KMC, Bejai,Mangalore, Karnataka

Developmental anomalies in the origin and branching pattern of the external carotid artery are not common. The level of the bifurcation of the common carotid artery and also the variations in the origin / branching pattern of the external carotid artery are well known and documented.

The variations in the level of bifurcation of common carotid artery and the branching pattern of the external carotid artery were studied on 95 cadavers of both sexes. The common, external and internal carotid arteries were dissected on both the sides. The level of carotid bifurcation was determined by comparison with the cervical vertebrae. Branching patterns of the carotid arteries were examined.

Anatomical knowledge of the origin, course, and branching pattern of the external carotid artery as well as the level of bifurcation of Common Carotid Artery will be useful to the surgeons to ligate the vessels during surgery in the head and neck region and to avoid unnecessary complications during Carotid Endarterectomy.

75. Calcification In Placenta

Sarkar M, Ingole IV, Ghosh SK, Bhakta A, Das RS,Tandale S and Tarnekar AM.

MGIMS, Sevagram

Calcification of placenta has been a topic of interest for long. Calcium is important in the regulation of numerous cellular functions, hence plays an important role for the growing foetus. According to some authors placental calcification was a manifestation of placental degeneration. The incidence of fetal distress in calcified placenta is four times more than in the not calcified group. The present study is designed to correlate between placental calcification and antepartum haemorrhage (APH), and weight of the baby. For the present study ten placentae (38-40 weeks) from singleton pregnancy were collected from Obstetrics Department of Kasturba Hospital Sevagram. 5 placentae were taken from cases of APH and 5 from normal pregnancy cases. Macroscopically calcium deposits are seen as pale coloured flecks which were firm and gritty in feeling on placental surface and parenchyma. The placentae were X-rayed using 42 kv for 0.2 seconds at a distance of 40 inches and 50 mm fine focus for radiological estimation of calcification in each placentae. Small pieces of tissue were collected from the placentae and processed for light microscope. 6 sections were studied after staining with Von Kossa. Increased calcification were seen in the basal plate, core of the villus, beneath the cytotrophoblast as compared to that of normal placenta.

76. Cloacogenic Bladder – A Case Study

BD Trivedi, Dimple Patel and Hiren Chavada.

Smt. N.H.L.M Medical College, Ahmedabad.

Cloacogenic bladder is also called persistent cloaca. It is a confluence of rectum, vagina and uretha as a single common chamber. The dilated sac like structure was present in the center of the abdomen. Entering the cloaca are the colon, the right ureter and the left ureter. A total of 2200 ml fluid was collected from the cloaca. The cloaca served as rectum and bladder. The infant had no anus. The only outlet was a thin narrow urethra.

Aetiology, development, pathogenesis and clinical co-relations will be discussed during the presentations.

77. Prune-Belly Syndrome A Case Report

AVani and S Saritha

M.N.R Medical College, Sangareddy

A dead male foetus of 20-week gestation was sent to Anatomy department, after Medical termination of pregnancy, due to congenial anomalies identified in routine ultrasound examination during antenatal checkup. On examination the foetus is presented with a big cystic swelling occupying the abdominal region. Lower limbs abnormally compressed anterior abdominal wall is not formed. On opening the cystic swelling bladder with two ureter and urethral orifice were identified, ureters were dilated. Associated with this, other congenital anomalies were found. These will be discussed in detail during presentation.

78. Development And Morphogenesis Of Testis

Damayanti N and Subhalakshmi Wahengbam

RIMS, Imphal

Development and histogenesis of testis was studied on 104 male fetuses. Histological study done using routine stains. Initially the testes were found as elongated yellowish tissue superolateral to the developing urinary bladder medial to mesonephros. The testis assumed ellipsoidal shape at 13 weeks with the epididymis on posterolateral aspect. Epididymis and testis were at the same level at 20 weeks; henceforth epididymis encroached the poles. The testis at this stage is ovoid and epididymis triangular. The testis at term is a miniature adult testis (one-fifteenth) while the epididymis remains relatively bigger. Testicular descent was normal in majority of the cases except in 7 where the descent was asynchronous with the left descending earlier. Earliest descended testis seen at 24 weeks and complete bilateral descent at 36 weeks. Histologically the testis at 9 weeks shows invasion of radially disposed sex cords. At 13 weeks tunica albuginea, tubular organization in the parenchyma and the Leydig cells were noticed. At 16 weeks, tunica vasculosa, rete testis and tubules were seen. At 17 weeks incomplete septa and lobules seen. At 24 weeks seminiferous tubules became numerous and peritubular mesenchymal tissue changes from single to 2-3 layers. Leydig cells were the most striking and most numerous in the stroma till 24 weeks. Pre-Sertoli cells were less numerous than spermatogenic cells before 28 weeks, thence it became more numerous. No distinct lumen but central vacuolation, full development of tunica vaginalis and complete septa were seen from 28 weeks. At 30 weeks coiled tubules were seen. Pale spermatogonia were more numerous than dark cells. At term the fetal testis had not yet attained the cytoarchitecture of the adult testis suggesting that testicular differentiation and growth continues postnatally.

79. Dissection Of Full Term Foetus (Limbs In Particular)

Damayanti N and DS Irungbam

Regional Institute Of Medical Sciences, Imphal

Scarcity of cadavers off and on led to the decision of dissection of full term foetus for teaching by the present authors. In this study 4 full term fetuses have been dissected. The findings are mostly comparable to the findings in the adult cadavers; however some significant differences are evident. In the upper segment of the lower limbs i.e. the thigh the medial compartment reveals the Gracilis which is triangular in shape unlike the ribbon like structure in adults. Similarly in the front of thigh, the Sartorius muscle is rather triangular. On the back of the thigh, the hamstring muscles are vivid and are comparable to that of adult. Popliteal fossa dissection exhibit similar comparable structures. The leg shows well developed muscles in all the three compartments and are sufficient for learning by the students. The soles could also be studied satisfactorily. Similarly dissection of the upper limb and its comparasion and contrast to that of adults has been done. Prominence of the Deltoid is evident. All the flexor muscles and extensor muscles could be studied easily albeit for the small size. Other areas could also be utilized for study. Such dissections and study thereof are better options than the models.

80. Dermatoglyphics In Relation To Diabetes Mellitus

Anirban Dasgupta And Ratnabali Sengupta

R.G.Kar Medical College, Kolkata

Dermatoglyphics the pattern of fingerprint, is incorporated in an individual right from the time of development of limb buds. Hence, it may sound amazing but yet agoging, that fingerprint of an individual may act as sibylline to admonish the individual regarding DM.

In this study, a diligent effort has been made to make dermatoglyphics as the apocalypter of this devastating disease.

81. Congenital Right Sided Diaphragmatic Hernia (Morgagni Hernia) – A Case Report

Amarappa N, TA Khan, KR Dakshayani and JH Sharieff.

GMC, Mysore, Karnataka.

During routine fetal autopsies conducted in the department of Anatomy, a rare case of right sided diaphragmatic hernia was observed in male fetus of 24 weeks. The autopsy findings revealed herniation of enlarged right lobe of liver along with the gall bladder, coils of intestine and subhepatic caecum and appendix. The left dome of diaphragm was intact and normal. The right dome of diaphragm was totally absent. The right lung appeared to be hypoplastic where as the left lung with pleura was normal. The left hypochondriac region showed normally placed stomach and spleen. No other external and internal anomalies were encountered. The present case gains significance because of its occurrence in male fetus in contrast to usual female preponderance.

In the light of above findings the details of the case will be presented.

82.”Pathology Unaffects The Linear Growth Of Fetal Long Bones”

K.B.SWAMY

AMC, Visakhapatnam, Andhra Pradesh.

The present study analyses the relative linear growth and proportionality of the long bones of l04 aborted fetuses based on the radiographic measurements of diaphyseal length and recorded crown heel length(CHL). The data is generated from the radiographs of the above 104 fetuses. The second data is generated from the autopsy records of the fetuses of soft tissue examination. In many cases it is found that there is no pathology while others showed some or other problems like placental disorders and some fetuses showed acute pathology like hyaline membrane disease. These cases are compared with those in which the pathology is proved in the postmortem examination. The above subjects are divided in to 10 groups according to the femur length and HCL measurements corresponding to the gestational ages between 16th and 40th weeks.

In this study it is revealed that the linear growth of the long bones is not significantly affected by the pre-natal pathology. It is also revealed that the proportionate relationship between the linear length of long bones and the crown heel length are stable and predictable. This fact is consistently utilised clinically by the radiologists and sonologists as well.

83. Spleen In Foetus

Trani, N Jayasree, R Rao, Ravindranath, CR Kiran, MR Reddy, M kala, D Gangulappa, and T Prasuna

KMC, Warangal, Andhra Pradesh

Of the 61 foetuses collected only 50 between 20-36 weeks were selected for the present study.

Foetuses were all injected with 10% formalin within 12 Hrs. Nearly 20 cc – 30 cc of 10% formalin is injected into Abdominal cavity, Thorax and cranial cavity, and then preserved for 24 Hrs. in 10% formalin with Glycerine. Later abdomen is incised, Spleen is removed for observation after recording relations.

As in the adults foetal spleen has been observed to vary in its parameters according to age of foetus.

All the parameters are essential informations to Ultrasonolgists and Neonatologist.

84. Foetal Appendix

MR Reddy, N Jayasree, R Rao, R Nath, Teresarani, M Kala, CR Kiran, D Gangulappa and T Prasuna

KMC, Warangal, Andhra Pradesh

Appendix is a part of large intestine responsible to maintain the immunity by producing lymphocytes.

Adetailed discription of appendix in adults have been given in all standered text books, but its discription in foetuses requires some more observations.

50 dead foetuses have been collected and injected with 10% formalin with in 12 Hours of birth. Appendix is observed in detail which will be very important information for Neonatologists for Neonatalsurgery.

85. Arch Of Aorta

MR Reddy, N Jayasree, R Rao, R Nath, Teresarani, M Kala, CR Kiran, D Gangulappa and T Prasuna

KMC, Warangal, Andhra Pradesh

Of the three parts of Aorta, Arch of aorta has a complicated development and this initiated to study only the Arch in foetus.

50 dead foetuses were collected and their age is calculated by measuring the crown rump length (CRL). After injection and preservation in 10% formalin for 24 Hours all the foetuses were dissected. Arch of aorta is observed in detail including its branches and relations for presentation and discussion.

86. Foetal And Neonatal Kidneys

MR Reddy, N Jayasree, R Rao, R Nath, Teresarani, M Kala, CR Kiran, D Gangulappa and T Prasuna

KMC, Warangal, Andhra Pradesh

Foetuses both aborted and still born were collected from different hospitals and preserved in 10% formalin. Out of 61 dead foetuses only 50 foetuses between the ages of II and III Trimisters have been studied.

Abdominal wall is incised and small intestines are removed to reach the posterior wall.

Kidney with all its relations have been observed in all the foetuses, recorded the findings to compare and discuss.

87. Prenatal And Neonatal Suprarenals

MR Reddy, N Jayasree, R Rao, R Nath, Teresarani, M Kala, CR Kiran, D Gangulappa and T Prasuna

KMC, Warangal, Andhra Pradesh

Dead foetuses from different hospitals of different ages have been collected, injected and preserved in 10% formalin.

After discarding few feotuses only 50 feoutuses were taken for the present study.

Abdomen of all the foetuses have been opened systematically, reached posterior abdominal suprarenals of both sides were observed in situ for its relations along with other essential parameters. Every essential findings observed will be presented and discussed in detail.

88. Gonads In Foetuses

MR Reddy, N Jayasree, R Rao, R Nath, Teresarani, M Kala, CR Kiran, D Gangulappa and T Prasuna

KMC, Warangal, Andhra Pradesh

All the Government hospitals were informed to preserve dead foetuses, in 10% formalin within 10-12 hours, all the foetuses were injected with 10% formalin.

Total number of foetus studied were 50 of which 32 were female and 18 were male.

After opening the abdomen ovaries in female and testis in male foetuses were identified, observed in situ and then removed for further observations.

Every parameter observed will be discussed in detail.

89. Musculature Of Intrauterine And Adjoining Isthmic Portions Of Fallopian Tube In Parous (Fertile) Women And In Women With Unexplained Infertility: A Comparative Study

Lt. Col. MS Ahuja and RK Zargar

Armed Forces Medical College, Pune.

The intrauterine and adjacent isthmic parts of the Fallopian tube represent a transition between the uterine cavity and the Fallopian tube. Many cases of infertility are encountered clinically where cause cannot be ascertained. These are classified as unexplained infertility. A comparison of musculature of intrauterine and adjoining isthmic parts of Fallopian tubes of fertile (parous) women and those with unexplained infertility is thus worthwhile. It can throw light on whether this part of the female reproductive tract is in some way contributing to the infertile state.

Specimens for this study were collected post hysterectomy and at postmortem. The intrauterine and adjoining isthmic portions were divided into four segments of around 0.5 cm each. Serial sections were then taken from medial to lateral side in each segment, stained and examined microscopically. Some of the specimens from women with unexplained infertility showed variations in musculature which were not encountered in specimens from fertile women. These observations and their possible significance are discussed here.

90. Electron Microscopy In Oral Premalignant Lesions

(1)Lt. Col S Ghatak and Col S Bhattacharya

Armed Forces Medical College, Pune.

Oral cancer is the sixth most common cancer in the world, accounting for approximately 4% of all cancers and 2% of all cancer deaths world-wide and is largely preventable. In India it is the commonest malignant neoplasm, accounting for 20-30% of all cancers.

Oral cancer is sometimes preceded by clinically visible lesions which are non-cancerous to begin with and which have therefore been termed pre-cancerous. White and red lesions of the oral mucosa are the most common pre-cancerous clinical lesions. However, there are no reliable histological features that can be used to predict whether the lesion will regress spontaneously or progress to cancer. The paper is a study of the ultrastructural changes in fibroblasts in oral premalignant lesions.

91. Incidence Of Heart Disease In The Male Population Of Some North Indian Districts Lt Col B.K Mishra

Armed Forces Medical College, Pune.

A study was undertaken in a male population of some North Indian districts of the incidence of Heart disease. All the candidates presenting over a period of one and a half years for enrollment in the defence forces at a defence enrollment centre were subjected to medical examination. The persons who had or were suspected of having disease were referred to the concerned specialist for confirmation of the disability. All those persons whose disability was adjudged by the concerned specialist as being within permissible limits were taken as fit and the others whose disabilities were beyond permissible limits were taken as unfit. The results are compared with similar studies and discussed.

92. Foetal MRI: Indications And Implications – A Review

Lt. Col. P. Haresh Kumar

Armed Forces Medical College, Pune.

Antenatal diagnosis of congenital anomalies are routinely detected on a second trimester or an early third trimester ultrasonographic examination. The images produced by a 2 D ultrasound even though are clear to experts still has certain pitfalls which lead to non detection of certain defects till birth.

Magnetic Resonance Imaging is playing an increasingly important role in the detection and classification of malformations not diagnosable by ultrasonography alone. Recently, advances in fast single-shot MR sequences have allowed high-resolution, high-quality imaging of the moving fetus. A brief account of the recent advances, indications, implications and prospective uses of foetal MRI will be discussed.

93. Assymetry Of Long Bones Of Upper Limb

BN Rao and B Indira Devi

M.I.M.S, A.P.

A study of assymetry of long bones of upper limbs of habitants of north-coastal Andhra Pradesh has been undertaken. In 50 upper limbs abstract length, weight and circumference of mid shaft of humerus, radius and ulna have been taken to study relative increase or decrease in parameters mentioned above and effect of dominance of handedness has been computed with the available data.

There is a significant assymetry in lengths and weights of long bones of upper limbs that were dissected in the anatomy department. Out of 50 upper limbs, 48 upper limbs belonged to males and 02 upper limbs belonged to female sex. Circumference at mid point of total length was measured using calibrated graph papers. Mean length of humerus, radius and ulna was greater on right side than the left side; so mean weight of humerus, radius and ulna was greater on the right side.

94. Variations In Supra-Orbital Notches Of Skulls Of North Coastal Andhra Pradesh

BN Rao and K Vijaylakshmi

M.I.M.S, Nellimarla, Andhra Pradesh.

10 varieties among notch, foramen (complete and incomplete), and none of the above were observed while computing the differences in the supra-orbital margins of skulls of north-coastal Andhra Pradesh collected from 20042006. There was an appreciable difference of the incidence of notch with notch, foramen with foramen has not been seen. Absence of all the three features has not been noticed in the skulls. The statistical significance will be discussed at the conference.

95. Morphometric Study Of Placenta and Report Of Abnormalities

B.N.RAO AND P.SRIDEVI

M.I.M.S, Nellimarla, Andhra Pradesh

Placenta is the mirror of maternal and foetal status. A total number of 70 placentae have been subjected to morphmetric analysis. The maximum weight of placentae recorded is 650 gms and the minimum weight is 50 gms. Circumference of the placenta ranged from 23-60 cms.diameter ranged from9-23cms. Length of the umbilical cord ranged from 1.5-35cms. There are about 36 battledore type of placentae, 1 placenta succenturiata. There is one monochorionic biamniotic placenta with 2 umbilical cords, bilobed placentae – 3, velamentous type – 1.

Vessel distribution: Disperse type – 30, Magisterial type –25.

Mean number of Cotyledons –18+. No Calcified areas, no infarction. Other details will be discussed at the conference.

96.”Cis Platinum Induced Embryotoxic Effects In Rat”

Vinod Kumar

Nalanda Medical College, Patna

The present work was designed to study the teratogenic effects of Cis-platinum in rat. Cis-platinum has been used as anticancer drug especially in male and female gonadal Carcinoma. Adult healthy female Albino rats were used and single dose of Cis-platinum (6mg./kg. Body weight) was given intraperitoneally on the 12th day of gestation. The pregnancy was confirmed from the sperm positive examination of the vaginal smear. The embryos were collected on the 20th day of gestation and the various types of congenital malformations have been observed in the growing fetuses. There is a little knowledge available regarding the teratogenicity of Cis-platinum. The present work is mainly based to observe the various kinds of congenital abnormalities at macroscopic level induced by Cis-platinum. Mortality rate was found in 28% in treated groups. Various anthropometric measurements like fetal weight, crown-rump length and tail length showed marked reduction in the treated group as compared to the control group. The limbs of the treated group revealed shortening and various types of digital defects in most of the cases and in a few cases the limbs were amputated, which is not reported earlier. The abnormalities like cleft palate, micrognathia and microcephaly were also observed in the treated groups. The findings indicate that the Cis-platinum induced severe embryotoxic effects, when given in the late phase of gestation.

97. Students Evaluation Of Various Methods Of Teaching / Learning Gross Anatomy

A.Bertha, Neeta V Kulkarni and Rajan Devasahayam

Dr.SMCSIMC and Hospital, Trivandrum

It is common knowledge that learning Anatomy is a nightmare for most of the medical students. It is further compounded by the fact that the scores in routine Anatomy examinations are not reflective of the efforts of the students, when compared to the other preclinical subjects. This study was undertaken to find out if, exposure to newer methods of teaching gross Anatomy, could create an interest in the student, leading to comprehension of the subject and better results.

100 medical students of 2005 batch of Dr.SMCSI Medical College, Karakonam, Trivandrum, were exposed to different methods of learning gross anatomy during the academic year Aug 2005-July 2006. The methods consisted of pedagogy, dissection, computer aided teaching in a computer laboratory with internet facilities (online teaching) and flash cards on skeletal muscles.

At the end of their course, feedback sheets were distributed to the students for evaluation. Evaluation was rated on a 5 point scale, on criteria like time consumption, creating interest in subject, revision, depth of knowledge acquired etc. The results were tabulated and statistically analyzed.

The results will be discussed in the conference.

98.”Triradii” In Palmar Dermatoglyphics Of Diabetic Cataracts

Sherke AR, Longia GS and Patil M

PCMSandR, Bhopal (M. P.)

The study consists of 400 subjects (200 patients and 200 controls). Palmar prints were taken by ‘Ink Method.’ Prints were analyzed to study the position of Axial traradii and total number of palmar triradii.

Results were tested for statistical significance. Significant increase in t2 triradius was observed. Also significant increase in number of triradii was observed in study when compared with controls.

99. Sono Anatomical Correlation Of Fetal Malformations-AScenario At FMU Of Fernandez Hospital, HyderabadSS Sarda, Suseela and H.Bindu

BMC and Fernandez Hospital, Hyderabad.

Fetal abnormalities and their early detection, parental counseling and prenatal correction whenever possible are a challenging task. With small family norm every pregency is a precious one and every child is an apple of eye to parents. Hence a proper prenatal care, diagnosis and management have become mandatory to obstetricians. An attempt is made to study the malformed dead fetuses by dissection and to compare them with previous ultrasound findings whenever available in fetal medicine unit of Fernandez Hospital at Hyderabad. Atotal of 20 dead fetuses were dissected and abnormalities of different systems analyzed and discussed. This type of study done on large scale will give an indication of prevalence of a particular abnormalitly and their causative factors for it, which may give an indication for the future steps for the prevention of their recurrence.

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