Elongated Odontoid Process of Axis Vertebra.

Introduction: Odontoid process is a bony projection of axis around which the atlas rotates. It measures 1 to 1.25 cms in length and projects upwards from the body of Axis. An elongated odontoid process may narrow the foramen magnum causing compressive neurological symptoms. It can cause cervical stiffness, serious restrictions of neck movement, and even a bone-derived torticollis. Observation: During routine osteology classes, we encountered an Axis vertebra with an elongated odontoid process. The measurements of the elongated odontoid process were taken using digital Vernier slide calipers. Conclusion: Elongated odontoid process can be mistaken for fracture of dens in radiological images; hence the knowledge of elongated odontoid process is useful for the radiologists, neurosurgeons and orthopaedicians for accurate diagnosis and treatment involving cranio-vertebral junctions.

Langer’s Axillary Arch and Its Clinical Implications.

Introduction: The axillary arch muscle of Langer is the most common anatomical variant of axillary musculature which is of clinical and surgical importance. It may lead to neurovascular compression syndrome in the cervicoaxillary region and can be misinterpreted while examining axilla and also impairs movements of shoulder joint. Observation: During routine dissection of axilla for undergraduate teaching, an unusual muscular slip in the left axilla was observed .The muscular slip was extending from lattisimus dorsi muscle to undersurface of pectoralis major muscle, arching over axillary vessels and cords of brachial plexus. Conclusion: The axillary arch may cause obstruction to axillary vessels and nerves and may be involved in thoracic outlet syndrome and shoulder instability. The knowledge of this muscular variant could help to minimize intraoperative complications related to surgeries in or nearby axilla such as mastectomy, breast reconstruction and axillary lymphadenectomy or lymph node biopsy.

An unusual case of Synostosis of first and second rib.

Introduction: Congenital anomalies of the ribs are not so common but they are usually discovered as an incidental finding on routine radiography. Bicipital rib results due to fusion of cervical rib with the first rib or the first rib with the second. Its occurrence is not uncommon and more frequently unilateral. Observation: During routine course of osteology teaching we observed that the first rib had fused with the superior surface of second rib, on the left side. Fusion between the ribs had occurred 3cms from the tubercle of the first rib obliterating the first intercostal space anteriorly. Conclusion: The incidence of synostosis of ribs is 0.3% of the population. It is usually asymptomatic but they may cause musculoskeletal pain or intercostal nerve entrapment. Involvement of the 1st rib is one of the causes of thoracic outlet syndrome. A rib anomaly usually indicates an underlying systemic disease and might need surgical intervention. Hence the present paper is an attempt to highlight its morphological implications and clinical significance

A study of disability in psychiatric patients

Background: Disability associated with mental illness is a major contributor to the global burden of diseases, accountingfor 25% of total disability and 16% of total burden as reported by World Health Organisation (WHO).Aim: To assess and compare the level of disability in various psychiatric disorders.Methods: A semi structured interview consisting of socio demographic details, and the Indian Disability Evaluationand Assessment Scale (IDEAS) were used to assess the level of disability among patients attending the psychiatricout- patient department.Results: Majority of the sample had mild and moderate disability.Conclusion: Appropriate intervention programmes of management and rehabilitation can improve the outcome.