A Case Report of Additional Slip of Pectoralis Major – Pectorotubero Fascialis Muscle

Variations in the pectoralis major (PM) muscles have been reported by various authors in the literature. We report a case of accessory slip of PM with variation in insertion which has not been reported in the literature to the best of our knowledge. This accessory slip was partially muscular getting inserted into medial lip of intertubercular sulcus (ITS) and partially aponeurotic getting inserted into lateral lip ITS, thus forming “H”-shaped pattern. Knowledge of such anatomical variation will create awareness among surgeons performing surgical reconstruction using PM muscle.

An osteological study of morphometry of hard palate and its importance.

Background: The hard palate is an essential part of human skull, the detailed knowledge of which plays an important role in the passive articulation of speech. Methods: The present study was conducted on 65 dry skulls from the department of anatomy, MVJMC & RH, Bangalore. With vernier caliper, palatine length, palatine breadth and heights were measured. Palatine index and palatine height index were calculated. Results: Mean palatine length was 48.47 ± 4.66 mm. Mean palatine breadth was 36 ± 4.41 mm and height was 8.62 ± 2.76 mm. According to the palatine index range, 66% of the hard palate belongs to leptostaphyline, 18.5% belongs to mesostaphyline and 15. 5% was brachystaphyline. As per palatine height index, 72.3% of hard palate showed chamestaphyline followed by 26.1% orthostaphyline and 1.6% hypistaphyline. Conclusions: These observations can be utilised for ethnic and racial classification of crania, anthropological studies, fabricating complete maxillary dentures for edentulous patients and performing certain surgical procedures in hard palate & soft palate.

Cadaveric Study on the Location of Pharyngeal Orifice of an Eustachian Tube in Relation to the Anatomical Landmarks.

Introduction: Eustachian tube is a communication between the nasopharynx and middle ear extending between the lateral wall of the nasopharynx to anterior wall of tympanic cavity.It maintains the equilibrium of air pressure on either side of the tympanic membrane for proper vibration of sound. The pharyngeal orifice of Eustachian tube is an important landmark for endoscopic surgeries and also for transnasal approach to infratemporal fossa. Materials and Methods: A total of 50 (25 right &25 left)sagittal section of head and neck specimens from adult formalin fixed cadavers from the department of anatomy, MVJ Medical college and Research Hospital, Banglore, India, were used for the study.The distance of pharyngeal orifice to posterior border of hard palate,C1 vertebra,posterior choana,tip of uvula, spehenoid sinus were measured with the digital Vernier caliper.The mean and standard deviation of these parameters were calculated. Conclusion: The knowledge of the relationship of Eustachian tube with anatomical landmarks would be useful to surgeons,otolaryngologists and radiologists.

A study on the incidence of retromolar foramen in South Indian adult dried human mandibles and its clinical relevance.

Background: The retromolar foramen is one of the most important non-metrical anatomical variants in the mandible. The present study describes the incidence of retromolar foramen in South Indian adult dried mandibles and its clinical relevance. Methods: One hundred South Indian adult dried mandibles of unknown sex were studied at the Department of Anatomy, MVJ Medical College, Bangalore for the presence of retromolar foramen. Its location, size, shape, distance of the foramen if present from the posterior border of socket for 3rd molar tooth, anterior border of ramus of the mandible were measured. Results: Retromolar foramen was present in 16 (16%) of the mandibles. Out of the 16 mandibles, it was present bilaterally in 3 (3%) mandibles and unilaterally in 13 (13%) mandibles (In 3 (3%) on the right side and in 10 (10%) on the left side). The mean diameter of the foramen was 1.33mm (range - 1.10-1.92 mm). It was oval in shape in 9 (9%) and rounded in shape in 7 (7%) mandibles. The mean distance of retromolar foramen from the posterior border of socket for 3rd molar tooth and anterior border of ramus were 6.15 mm (2.23-12.10) and 8.02 mm (3.24-13.12) respectively. Conclusions: The knowledge about the incidence of the retromolar foramen is important for dental surgeons during various anaesthetic, implantation and surgical procedures of the mandible, especially during extraction of the lower last molar tooth.

A Clinico-Pathological Study of Hemophilia in Rural Set up of Karnataka.

Haemophilia is the most common inherited coagulation disorders, with X linked recessive inheritance, affecting the males while females are the carriers of the disease. Haemophilia A and Haemophilia B are the commonest form of Haemophilia encountered and they result from defect in Factor VIII and Factor IX gene respectively. A clinico hematological study with suspected coagulation disorder was conducted over a period of two years, from June 2008 to July 2010. Of the 76 patients visited OPD, based on clinical presentation and family history, 50 cases were categorized as Hemophilia A or B after laboratory investigations. Majority (41) of the cases were categorized as Hemophilia A & only 7 cases were Hemophilia B. The mean age group of the patients was 2.87 years with an age of onset ranged between 3rd day to 5.6 years. All the cases were males and only a very rare case of female Hemophilia patient was noted. Thirty five (52.23%) patients had positive family history of bleeding. In 12 families (18.75%) there had been consanguineous marriage. Spontaneous bleeding was the predominant presenting symptom followed by Hemarthrosis and prolonged post traumatic bleeding. The knee joint was most commonly involved. Coagulation screening tests showed that 60% patients had prolonged activated partial thromboplastin time (APTT) with an average of 88 seconds. Mixing and substitution studies were very useful in distinguishing between Hemophilia A & B. Factor assays in both Hemophilia A & B showed 66% of cases with severe factor deficiency, 26% moderate and 8% with mild deficiency. In the present study an effort is made to explore, elucidate and document the clinico haematological correlation of Hemophilia in this part of Karnataka.

Urogenital Vascular Anomalies with Bilateral Kinking of Ureter: A Case Report

Variations in the urogenital vascular anomalies in the abdomen are very common. However, they warrant attention due to their importance in operative, diagnostic, and endovascular procedures. During routine dissection of abdomen in a male cadaver, unique urogenital vascular anomalies were observed. On the right side, the right renal artery was found to be originated from the abdominal aorta at the level of L2 and divided into five branches; the right testicular artery and inferior suprarenal artery originated from the lower branch. We also observed, accessory renal artery arising from abdominal aorta at the level of L3 and double renal veins on right side. On the left side, we found left renal artery originating from the abdominal aorta at the level of L2 and divided into two branches. Double testicular (medial and lateral) arteries were also observed. In addition to these vascular variations, bilateral kinking of ureter at the pelviureteric junction was also observed. Although the variations in the origin of urogenital vessels in the abdomen are common, deeper understanding of the urogenital vascular variations and their relations to adjacent structures is significant during surgical and radiological procedures.

Primary amenorrhea varied etiology

Investigation of primary amenorrhea is usually initiated by the age of 14 years if there is delayed puberty absent secondary sexual characteristics and absent menses, or no menstruation within 4 years of the onset of adrenarche and thelarche. We established diagnosis in our 3 cases on the basis of chromosomal analysis, hormonal analysis, diagnostic laparoscopy, and histopathological examination of the samples biopsied. We identified 3 varied etiologies

Twin intrauterine and cornual gestation in a case of triplet pregnancy

Ectopic implantation with in-vitro fertilization-embryo transfer may occur in the cornu or tubal stump, which is otherwise rare. Our patient with previous left salpingostomy and right salpingo-oophorectomy had 4 embryos transferred through in vitro fertilization out of which 3 were successfully implanted with twin intrauterine gestation and cornual pregnancy. The cornual pregnancy ruptured at 12 weeks of gestation and the twin intrauterine pregnancy had a successful outcome

Placenta previa in a referral hospital in Oman

To determine the incidence of placenta previa associated pregnancies, to find out the strength of association of identified risk factors with the major placenta previa associated pregnancies and to identify predictors for preterm outcome. Records of women with placenta previa, who delivered at Nizwa Hospital, Al-Dakhliya region, Sultanate of Oman between October 1998 and September 2002, were analyzed retrospectively utilizing a case control approach. An incidence of 0.6% for placenta previa was noted in our study. Nearly two thirds [64.8%] of the pregnancies resulted in antepartum bleeding. Pregnancies with major placenta previa constituted 72% of all the subjects. Higher parity [>/= 5], maternal age [>/= 30] and history of previous abortion had high odds of association with major placenta previa of 2.1, 2.4 and 2.5. Antepartum hemorrhage was not significantly associated with pregnancies presenting with major placenta previa [odds ratio [OR] 1.3; p>0.05]. The proportion of preterm deliveries was 55.5% in the study. There was a significant association between preterm outcome and presence of antepartum hemorrhage [OR 10.8; p<0.001]. In spite of higher maternal age, parity and previous abortions having high odds of presenting in pregnancies with major placenta previa, no significant statistical association could be proven. Also, no significant difference among pregnancies presenting with major or minor placenta previa as regards the preterm outcome, could be established. Antepartum hemorrhage, irrespective of severity, was a strong predictor of preterm outcome