The Morphology and Clinical Considerations of Mucosal Folds of Cystic Duct

Introduction: The cystic duct connects the gallbladder to the extra hepatic bile duct. In its endoluminal surface are the mucosal folds which are characteristic of the duct. Aim:-The aim was to study the length and mid-length diameter of the cystic duct and the mucosal folds of its endoluminal surface with respect to their number, location, and orientation. Subjects and Methods: This study was carried out in the Anatomy Department of Parul Institute of Medical Sciences and Research, Vadodara, on 40 specimens of 10% formalin fixed human cystic ducts, from 2015 to 2018, after obtaining permission from the Institutional Ethics Committee. The cystic duct was isolated and its lumen was exposed by an incision parallel to its length to study the folds. Results: The length of the cystic duct was between 0.4 to 4.2 cm, and the diameter was between 0.2-0.6cm. The mucosal folds were present in 38(95%) specimens and were absent in two (5%). The maximum number of mucosal folds present in a specimen was eleven. In the 25 (62. 5%) specimens they spanned the entire length and in 13(32.5%) they were present only in the proximal part. Their disposition was either oblique, transverse interdigitating, combination type or saccular. Conclusion: It gives insight into the internal morphology of the cystic duct. Various types of mucosal folds have been described, the knowledge of which will be important to the laparoscopic surgeons during various interventional approaches undertaken in this region.

Observations of parrots at a geophagy site in Bolivia

Geofagia, o consumiendo suelo, es conocido en un gran variedad de grupos de animals, pero es particularmente común entre las gucamayas y los loros de la familia Psittacidae. La teoría en curso sugere que los loros Neotropicales comsumen suelo para neutralizar toxinas en la dieta como semillas y frutas inmaduras y como suplemento mineral. Aqui, documentamos el acontecimiento de consumiendo suelo a un sitio en la selva de tierra-baja en Bolivia. Recordamos seis especies de loro con un maximo de 1,044 aves en un día. Aratinga weddellii, Pionus menstruus y Ara severa (con maxima de 654, 337 and 108 aves por cada una) estaban las especies mas numerosas que visitaron esto sitio. Recomendamos la protección formal para el Valle de la Luna por incorporando esto sitio en el Paque Nacional Carrasco.

Beneficial effects of yoga lifestyle on reversibility of ischaemic heart disease: caring heart project of International Board of Yoga.

OBJECTIVES: Yoga based lifestyle modifications have been earlier shown to be beneficial in coronary artery disease in a small number of patients. We evaluated the role of lifestyle modification based on Yoga techniques, stress management and dietary modifications in retardation of coronary artery disease. METHODS: This prospective, controlled, open trial included angiographically proven coronary artery disease patients (71 patients in study group and 42 patients in control group). They were assessed clinically, by biochemical parameters, stress myocardial perfusion and function studies and coronary angiography and on psychological parameters. The study group patients were given a family based Yoga Programme which included, control of risk factors, dietary modifications and stress management for a period of one year. The patients were assessed at baseline, at frequent intervals and at the end of one year. RESULTS: At the end of one year of yoga training, statistical significant changes (P<0.05) were found in serum total cholesterol (reduction by 23.3% in study group patients as compared to 4.4% in controls); serum LDL cholesterol (reduction of 26% in study group patients as compared to 2.6% in the control group), regression of disease (43.7% of study group patients v/s 31% control group on MPI and 70.4% of study group v/s 28% of control group on angiography) arrest of progression (46.5% study group v/s 33.3% control group on MPI) and progression (9.9% of study group vs 35.7% of controls on MPI, 29.6% of study group v/s 60.0% of controls on angiography). At the end of the study improvement in anxiety scores was concordant with the improvement seen in the MPI. No untoward effects of the therapy were observed. CONCLUSION: Yoga based lifestyle modifications help in regression of coronary lesions and in improving myocardial perfusion. This is translated into clinical benefits and symptomatic improvement.

Mounier-Kuhn syndrome.

A variant of Mounier-Kuhn syndrome is reported where the patient had bronchiectasis with tracheo-bronchomegaly. The patient also had facial anomalies and asthenozoospermia. This combination has not been reported so far in the literature.