Open Lip Schizencephaly with Agenesis of Corpus Callosum: A Rare Embryological Defect In Combination.

A five week old newborne presented with recurrent abnormal movements . The child was borne of normal parents with non consangious marriage . There was no history of any ailment of mother during pregnancy and she was not on any drugs. The baby was borne by normal delivery and The CT Scan of the head showed Schizencephaly with Agenesis of Corpus Callosumwith gyralmalformation. Therewere no associated anomalies. Facial features were well developed and the muscle tone and power of the child was normal. The blood investigations were normal as was metabolic profile.

Anterior cerebral artery – Anatomic region favoring aneurysms: Case series.

Aneurysms or Dilatations in the vessels which are prone to rupture occur at bifurcations of large arteries at the base of brain. Rupture occurs into the sub-arachonoid space in the basal cisterns and into parenchyma of the brain. 80-90% of these aneurysms occur at circle of Willis. Commonest types are the Berry’s aneurysms and commonest sites are at junction of anterior communicating artery with anterior cerebral artery and bifurcation of middle cerebral artery.

Liver lacerations in abdominal trauma – Management based on anatomical Knowledge: Case series.

The Liver is commonly injured following penetrating trauma and the second most commonly injured organ following blunt trauma. Due to the soft consistency of the liver parenchyma the injuries are often minor and can be easily managed. The article pinepointd the various anatomical and surgical characteristics and how they relate to liver injuries and trauma management. We reported here two cases of abdominal trauma where both the patients had liver injuries in the form of laceration and bleeding within the substance of liver. The first case was of a young patient who had a high velocity road traffic accident and was brought to the casualty in a state of shock. The Second pattient had a fall from bike and fell on the road by his side.

Injuries to the Spine Mechanics : Anatomical and Orthopedic Aspects.

Vertebral injuries can occur as isolated injuries or may be associated with other injuries. Recognition of the level of injury is important along with the mechanism of injury. The article describes the various types of injuries of the vertebral column along with the main mechanisms and the difference between the types of injuries in the vertebral column.

Effectiveness of pulse oximetry screening for congenital heart disease in asymptomatic new-borns.

Background: Congenital Cardio-Vascular Malformations (CCVMs) are relatively common with a prevalence of 5-10 in every 1000 live births. CCVM represents a new-born condition that would be ideally suited to a screening program if simple and reliable methods were available. Pulse oximetry has been proposed as a screening method for the detection of congenital heart defects. Methods: Hospital based prospective non-randomized study conducted over a period of one year at the department of pediatrics in G.B. Panth hospital (Neonatology) and L.D. hospital (Neonatology). A total of 1200 asymptomatic new-borns attending G.B. Panth, neonatology/L.D. neonatology were screened with pulse oximetry. Oximetric screening for CCVM was performed by obtaining a single determination of postductal saturation at >24 hours. All new-borns underwent additional evaluation by echocardiography. Results: Out of 1200 newborns screened three had postductal saturation ≤95%. Echocardiography revealed TGA (transposition of great vessels) in one; TA (truncus arteriosus) in other and third one had structurally normal heart on echocardiography. There was one false negative screen (found in the inpatient records of G.B. Panth hospital). The sensitivity, specificity, positive predictive value and negative predictive value of pulse oximetry in screening for CCVM in asymptomatic new-borns was found to be 66.67%, 99.9%, 66.67% and 99.9% respectively. Conclusion: This screening test is simple, non-invasive and inexpensive. The sensitivity, specificity, and predictive value in this population were satisfactory, indicating that screening should be applied to larger populations, particularly in developing countries where lower rates of detection result in increased CCVM prevalence in asymptomatic new-borns.

Cavernous Transformation of Portal Vein : A Rare Anatomic Development with Emphasis on Anatomy and Physiology of Portal Blood Flow.

Portal vein contributes to more than 70 % blood flow to the liver the significant increases in portal venous blood pressure is associated with major systemic manifestations. Having a knowledge about Portal Blood supply is important tio any clinician, gastroenterologist or any Hepatic Surgeon. The Article outlines the rare development of Portal Cavernoma in a patient who had Portal Hypertension. Portal cavernoma is a consequence of portal vein thrombosis. We Present a case of a lady with mild Right hypochondriac pain who on evaluation was found to have Cavernomatous transformation of Portal vein without any other abnormality.

The Rare Case of Left Retro Aortic Renal Vein: Surgico Anatomic Ramifications of the Abnormality.

The Article presents a rare Anomoly of Course of Renal Vein where it lies behind the Aorta . The Consequence of failure to Recognize this clinical entity can be dangerous if left Undetected. This Vein is located between the Aorta and the Vertebrae. The Patient presented with left Flank Pain and on Evaluation was found to have Left RetroAortic Renal Vein.

ABNORMALITY IN ENCHONDRAL OSSIFICATION ENCHONDROMATOSIS (A Rare Severe Clinical case with Embryological and Radiological perspective).

In humans sometimes abnormal intracartilaginous mode of ossification can lead to formation of a bony lesion referred to as Enchondroma. Enchondroma can present as a solitary lesion that involves metacarpals, metatarsals, and phalanges in most of the cases or as multiple lesions. We present a case of a 28 year old male who presented with pain in his forearm and digits on both sides. The pain was of mild nature .Rest of the general and skeletal survey was normal. He was followed with radiographs which revealed multiple enchondromata bilaterally. On history there was no familial history of similar or related disease.

MORPHOLOGICAL AND MORPHOMETRIC STUDY OF JUGULAR FORAMEN IN SOUTH INDIAN POPULATION.

Background: The jugular foramen, the bony opening on the base of skull, is an opening through which pass the ninth, tenth, and eleventh cranial nerves, two dural sinuses, and the meningeal branches of the occipital and ascending pharyngeal arteries. The increasing use of modern diagnostic procedures and new surgical approaches has created a need for much more detailed anatomical studies and explanations. This article reveals some additional features. Material and Methods: 324 jugular foramina of skulls of persons of unknown age and gender were examined. The morphological characteristics of all the investigated jugular foramina were described, measured, and compared, taking into consideration their side. Results: Jugular foramina were studied for a review of its morphology, morphometry and its comparison with previous studies. Different shapes and sizes of jugular foramen were seen. Laterality was also noticed, compartmentation was also observed which was found to be statistically significant. Conclusions: A detailed examination of the jugular foramen anatomy was performed. The main types of jugular foramina and the frequencies of bipartite or tripartite division were established. Several dimensions of the parts of the jugular foramen were measured. Some new data could provide important information about the anatomy of the jugular foramen for reliable surgical interventions in this area.

Importance of lymphatic’s in dissemination of breast cancer-Anatomical, pathological, surgical and prognostic implications.

Background: The Breast cancer is one of the most common cancers in females with many subtypes. Breast cancer can spread via hematogenous route as well as lymphatic routes. Knowledge of the lymphatic drainage of breast is required not only for the performance of surgical procedures but also in planning therapeutic radiation, predicting sites of locally recurrent disease. The lymphatic drainage of the breast is considered rich, and identification of the major pathways allows a surgeon to predict the sites most commonly containing lymph-borne metastases. Careful inspection and palpation of Axillary, supraclavicular and parasternal sites for nodal involvement is thoroughly performed for recording location, size, consistency, shape, mobility, fixation, and other characteristics of any palpable lymphadenopathy. Local implications of lymphatic obstruction can be Preau D orange appearance and edema while as distant manifestations can be involvement of Nodes along with dissemination to other organs. The further the lymphatic dissemination , the lesser the favourable prognosis . Pathologic stage combines the findings from pathologic examination of the resected primary breast cancer and axillary or other regional lymph nodes. This connotes the importance of Status of Lymphatics in Breast Cancer .

The gem in gastrocnemius: the fabella -Anatomical and radiological perspective.

Background: Sesamoid bones are small seed like bones which can be found in the hand, knee, and foot. Their unique structure works to protect the tendon, and to increase its mechanical effect. Examples of sesamoid bones include the os acromiale, os styloideum, metacarpal and hallux sesamoids, patella, os trigonum, os calcaneus secundarius, accessory navicular, os peroneum, and os intermetatarseum. The Sesamoid bones are so named because they resemble a sesame seed. WE present a brief description about Fabella , a small Sesamoid bone occasionally found in the lateral head of Gastrocnemius muscle, its surgical and medicl importance. Presence of Fabella can be confused with certain Orthopedic Problems.

Hydatid disease of liver and disseminated hydatidosis: anatomical, microbiological and radiological perspective.

The article underlies the geographic locations of the disease as the disease is not uniformly distributed and is common in certain parts of the world and rare in other parts. The article tries to summarize the microbiological aspects along with the anatomical and surgical perspectives for in depth knowledge and reasons for spread of disease. The photographs indicate the radiological spectrum of the disease in line with the text.

Surgical significance of variations in anatomy in the biliary region.

Variations in the anatomy of the gallbladder, the bile ducts, and the arteries that supply them and the liver are important to the surgeon, because failure to recognize them can cause iatrogenic injury to the biliary tract. A surgeon should be always be careful while operating in this area. In addition these anomalies are associated with a range of other congenital anomalies, including biliary atresia and cardiovascular or other gastrointestinal malformations, biliary lithiasis, choledochal cyst, anomalous pancreaticobiliary junction etc, so a look out for other anomalies should be carried out simultaneously.

Vestibular schwannoma: anatomical, medical and surgical perspective.

The term "acoustic" is a misnomer, as the tumor rarely arises from the acoustic (or cochlear) division of the vestibulocochlear nerve. The correct medical term is vestibular schwannoma, because it involves the vestibular portion of the 8th cranial nerve. They are benign, rather rare tumors. They expand in size and grow larger; they can push against the brain. While the tumor does not actually invade the brain, the pressure of the tumor can displace brain tissue.