Morphometric analysis of palmaris longus muscle belly and its tendon: a cadaveric study in north india

Background: The Palmaris Longus Muscle is the first option in tendon graft procedures, for it fulfills the necessarycriteria of length, breadth and easy surgical accessibility. Therefore, the present study was performed with thepurpose to determine the morphometry of PL in North Indian population.Materials and methods: Material for the present study consisted of 40 limbs of different age group andsex(28Males&12Females). The limbs were made available in the Anatomy department for dissection purpose atSGRDIMSAR, Amritsar, Punjab. The length and width of the PL-Muscle Belly(PL-MB) and PL-Tendon(PL-T) weremeasured with the help of digital Vernier caliper. The unpaired t test was used to study the significance of thedifferences in male and females and right and left PLM.Results: The mean MBL and MBW of the PL was more (6.195+1.788cm & 2.095+0.723cm) on right side than(5.895+1.748cm & 1.920+0.740cm) on the left side. The mean TL on left side (15.690+1.336cm) was slightly morethan the right side (15.625+1.489cm) whereas TW on right side (0.435+0.099cm) was found to be slightly morethan the left side (0.426+0.108cm). It was also observed that the mean MBL, MBW, TL and TW was more in malecadavers as compared to female cadavers.Conclusion: PLM has importance in medical clinic, surgery, radiological analysis and has great significancewhen used as a donor tendon in reconstructive surgeries. Thus there are advantages to know the length and widthof the PL tendon for being the ideal choice for tendon graft procedures.

Management Of Asthi-majjagata Vata W.s.r. To Avascular Necrosis (avn) Of Femoral Head Stage 3 By Panchakarma - A Case Study

Avascular necrosis (AVN), also called osteonecrosis, aseptic necrosis, or ischemic bone necrosis, is a condition that occurs when there is loss of blood supply to the bone, an interruption to the blood supply causes bone to die. If not stopped this process eventually cause the bone to collapse. It is the most challenging condition of the present era in orthopedics. In Ayurveda it can be co-related with the Asthi Majja Gata Vata due to similar sign and symptoms of Avascular necrosis of neck of femur. Aim and objectives: To assess the efficacy of Manjisthadi Kshara Basti, Rooksha Choorna Pinda Swedana, Pizhichil and Shastikashali Pinda Swedana in the management of AVN. Objective was to stop the further deterioration of the hip joint and to reduce the chances of surgical intervention in managing AVN. Materials and methods: A diagnosed and non operated case of Avascular necrosis of stage 3 with complaints of pain of bilateral hip joint, restricted movements and limping gait approached the out-patient division of the hospital and was managed by Rooksha Choorna Pinda Swedana, Manjisthadi Kshara Basti, Pizhichil and Shastikashali Pinda Swedana. Observation and Result: Significant improvement was noticed after the treatment. Pain was reduced significantly with improvement in range of movement. Patient was able to walk and climb stairs after the treatment without pain and stiffness. There was reduction in VAS scale, marked improvement was noticed in Harris Hip Score.

Effect of Maturity And Birth Weight On Umbilical Cord Blood Lipid Profile: A Fetal Programming Phenomenon

Background:The recent research on "fetal programming hypothesis" has totally revived the mechanistic understanding of triggering factors responsible for development of cardiovascular diseases (CVDs). As deranged lipid profile is associated with increased predisposition to atherosclerotic CVDs, we planned to study effect of fetal maturity and birth weight on umbilical cord blood lipid profile. Methods: A hospital based cross sectional study including 200 neonates satisfying inclusion criteria was carried out. The umbilical cord blood samples of selected neonates were collected and analysed for lipid profile (Total Cholesterol (TC), Triglycerides (TG), High Density Lipoprotein Cholesterol (HDL-C), Low Density Lipoprotein Cholesterol (LDL-C) and Very Low Density Lipoprotein Cholesterol (VLDL-C)) in order to be compared among groups of neonates based on maturity and birth weight. Results: The preterm neonates had statistically significant higher levels of umbilical cord blood TC, TG, LDL-C and VLDL-C (with P values of 0.025, 0.001, 0.045, 0.007 and 0.045 respectively) while lower but statistically insignificant (p value of 0.131) levels of HDL-C in as compared to full term neonates. The low birth weight neonates also had statistically significant higher levels of TC, TG, LDL-C and VLDL-C (P values of 0.001, 0.032, 0.00001 and 0.032 respectively) but statistically significant (P value of 0.034) lower levels of HDL-C in umbilical cord blood as compared to normal birth weight neonates. Conclusion: The results suggest that prematurity as well as low birth weight have deleterious effect on umbilical cord blood lipid profile resulting in more atherogenic lipid levels. This could be regarded a triggering factor responsible for development of CVDs in later life. This observation not only conciliates with fetal programming hypothesis but also indicates that its effect is evident (in the form of altered lipid profile) even at the birth in such programmed neonates.

Polymorphism of glutathione S-transferase M1 and T1 genes and susceptibility to psoriasis disease: A study from North India

Background: Increased oxidative stress and resulting inflammation has been emphasized as a factor in the pathogenesis of many diseases including psoriasis. Glutathione S-transferases (GSTs) protect against oxidative stress, inflammation, and genotoxicity. Polymorphisms in the GST genes may lead to an imbalance in pro- and antioxidant systems resulting in the increased production of reactive oxygen species that could influence the pathogenesis of psoriasis. Aim: The aim of this study was to investigate the association between GSTs (GSTM1 and GSTT1) gene polymorphism in patients with chronic plaque psoriasis as a factor in the susceptibility and development of psoriasis. Materials and Methods: We assessed 128 patients with psoriasis and 250 age- and sex-matched healthy controls. Genomic DNA was extracted from peripheral blood by the phenol chloroform method. The null GSTT1 and GSTM1 genotypes were identified by multiplex polymerase chain reaction (PCR) method. Results: The null genotype of GSTM1 and GSTT1 was seen in 45.3% and 40.6% in psoriasis patients whereas in the controls it was 34.4% and 20.0%, respectively. A significant association was seen between the null alleles of the GSTT1 (OR = 2.74) and GSTM1 (OR = 1.58) alone or in combination with tobacco use (P < 0.001) and psoriasis risk. The presence of both null genotypes of GSTM1 and GSTT1 further increased the risk of psoriasis (OR = 3.52) when compared with the positive genotypes of GSTM1 and GSTT1. Limitations: A major limitation of this study was the small sample size. A large epidemiological study is necessary to confirm these findings. Conclusions: The null genotype of GSTT1 is a strong predisposing factor for psoriasis in North India.

The study of cephalic index in North Indian population / Estudio de Índice cefálico en una población del norte de India

Cephalic index (CI) and head shape are greatly affected by geographical, sex, age and racial factors. Such data is of great medico legal and forensic importance which indicates that cephalic index can be used as marker of ethnicity. There is less published literature about cephalic index of Punjab population. Hence, we undertook this study to document the cephalometric characteristics and gender differences in cephalic index of Punjabi community. Head length, head breadth and CI were determined for 500 medical students (17­23 years) of Punjab. The mean cephalic index for males was 80.52 and for females 84.32 which was statistically significant. On comparison with the existing literature the Punjabi community can be categorized as Brachycephalic/ Hyperbrachicephalic. This is of immense value in forensic science for facial reconstruction of disputed identity, orthodontics, different oral & maxillofacial surgery or craniofacial surgery, paleoanthropology and phylogeography.

El índice cefálico (IC) y la forma de la cabeza se ven afectados en gran medida por las regiones geográficas, el sexo, la edad y los factores raciales. Este tipo de dato son de gran importancia legal y forense dado que el IC puede ser utilizado como marcador de la etnia. Hay escasa literatura publicada sobre el IC de la población de Punjab. Por lo tanto, se realizó este estudio para documentar las características cefalométricas y las diferencias de sexo en el IC de una comunidad Punjabi. La longitud y ancho la cabeza, junto al IC, fueron determinados en 500 estudiantes de medicina (17­23 años) de Punjab. El IC medio para los hombres fue de 80,52 y para las mujeres 84,32, lo que fue estadísticamente significativo. En comparación con la literatura existente, la comunidad Punjab puede ser categorizada como braquicefálica/ hiperbraquicefálica. Esta información es de importancia para las ciencias forenses en relación a la reconstrucción facial con fines de identificación, como así también para la cirugía oral, maxilofacial, craneofacial, la paleoantropología y la filogeografía.

Analysis of Fibularis Tertius in Terms of Frequency, Morphology, Morphometry and Clinical Significance in North Indian Cadavers.

Introduction: The fibularis tertius muscle has always enjoyed the distinction of being an exclusively human structure and as such it has helped to separate man from the lower animals. Myocutaneous flaps have been progressively used in surgical reconstruction in the lower limb injuries requiring the use of muscles which result in less functional damage as flaps. Aim: Our study is aimed to evaluate frequency, morphology, morphometry and use of the fibularis tertius muscle as flaps in lower limb injuries. Materials and Methods: Sixty lower limbs from formalin preserved cadavers (28 male and 2 female) were dissected and evaluated for the following parameters: origin of muscle, distal insertion, nerve supply, frequency, morphology, morphometry and any variation regarding this muscle. Results: The fibularis tertius muscle was detected in all the cases (60 limbs). Origin of all the cases were found at the interosseous membrane, anterior border of the fibula, and anterior intermuscular septum. Most distal insertions were found at the medial and dorsal sides of base of the 5th metatarsal bone (98.34%). Mean value of muscle belly length was 21 cm and width was 1.9 cm. The mean length of the distal tendon with no muscle fibers up to insertion was 6 cm, and the mean width was 0.5 cm. Conclusions: The fibulari stertius muscle is frequent and has a distinct morphology, making it a feasible option for use as graft. Knowledge of these variations may have useful clinical applications in cases of leg or foot trauma requiring tendoplasty or tendon transfer operations.

Variation in the Number and Position of Nutrient Foramina of Long Bones of Lower Limb in North Indians.

Aims and Objectives: The major blood supply of the long bones is through the nutrient arterywhich enter through the nutrient foramina leadinginto an oblique nutrient canal. The presence, number, position and distances from the various prominent landmarks on the bone have medical as well as surgical significance. The present study was done on the long bones of North Indians to know the mean values of the number, position of nutrient foramina and distance from various landmarks on the bones and ultimately to compare with other populations. Materials and Methods: The present study consists of 180 long bones of lower limb (60 femora, 60 tibiae, 60 fibulae) which were taken from Department of Anatomy, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah (Amritsar), India and studied carefully for the number, position and distance of nutrient foramina in relation to length and from the proximal epiphysis of the long bones. Also the anteroposterior and lateromedial diameter of the bone at the level of nutrient foramen were studied. Main outcome measure: Variations in number, position and distance in relation to length and from proximal epiphysis of long bones was seen. Results: The nutrient foramen of femur was located on the linea aspera in 76.50% of cases(39% in interstice 9.5% on the lateral lip and 28.00% on the medial lip of the linea aspera), 18.50 %on the medial surface and 5%.on the lateral surface. Nutrient foramen of tibia was located in 95.50% of cases under the soleal line at the average distance of 119.8 mm from intercondylar eminence to the nutrient foramen, on the soleal line in 4%and on the lateral border in 0.50% of cases. Nutrient foramen of fibula was found on the posterior surface in 65 % of cases, in 15% on the medial surface, on the interosseous border in 10% ,on the lateral surface in 7% and on the posterior border in 3% of cases. Conclusion: This study will provide the ethnic data for comparison among various populations. It is also helpful in various surgical procedures and in interpretation of radiological images.

Variation in the Number and Position of Nutrient Foramina of Long Bones of Lower Limb in North Indians.

Aims and Objectives: The major blood supply of the long bones is through the nutrient arterywhich enter through the nutrient foramina leadinginto an oblique nutrient canal. The presence, number, position and distances from the various prominent landmarks on the bone have medical as well as surgical significance. The present study was done on the long bones of North Indians to know the mean values of the number, position of nutrient foramina and distance from various landmarks on the bones and ultimately to compare with other populations. Materials and Methods: The present study consists of 180 long bones of lower limb (60 femora, 60 tibiae, 60 fibulae) which were taken from Department of Anatomy, Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah (Amritsar), India and studied carefully for the number, position and distance of nutrient foramina in relation to length and from the proximal epiphysis of the long bones. Also the anteroposterior and lateromedial diameter of the bone at the level of nutrient foramen were studied. Main outcome measure: Variations in number, position and distance in relation to length and from proximal epiphysis of long bones was seen. Results: The nutrient foramen of femur was located on the linea aspera in 76.50% of cases(39% in interstice 9.5% on the lateral lip and 28.00% on the medial lip of the linea aspera), 18.50 %on the medial surface and 5%.on the lateral surface. Nutrient foramen of tibia was located in 95.50% of cases under the soleal line at the average distance of 119.8 mm from intercondylar eminence to the nutrient foramen, on the soleal line in 4%and on the lateral border in 0.50% of cases. Nutrient foramen of fibula was found on the posterior surface in 65 % of cases, in 15% on the medial surface, on the interosseous border in 10% ,on the lateral surface in 7% and on the posterior border in 3% of cases. Conclusion: This study will provide the ethnic data for comparison among various populations. It is also helpful in various surgical procedures and in interpretation of radiological images.

Comparative pharmacognosy of Pashanbhed.

Background: Pashanbhed is a commercially available diuretic and lithotropic drug, used to treat renal problems. It is a controversial name as it is assigned to various plants such as Bergenia ligulata, Kalanchoe pinnata, Coleus aromaticus and Rotula aquatica. Objective: To perform the comparative preliminary phytochemical screening, diuretic activity, and thin layer chromatography (TLC) fi nger printing profi le of three plants (B. ligulata, C. aromaticus, and K. pinnata), most commonly used as Pashanbhed. Materials and Methods: Diuretic potential of methanolic extract (ME) of three plants were evaluated at two dose levels (500 and 1,000 mg/kg p.o.), using normal Wistar rats (Lipschitz method). Furosemide (20 mg/kg p.o.) was used as a standard drug. The effect on urine output and electrolyte changes were measured for 24 h and compared. All MEs were screened preliminarily for their constituents and their TLC fi nger printing profi les were prepared. One-way analysis of variance (ANOVA) followed by Bonferroni’s multiple comparison test. P < 0.05 was considered statistically signifi cant. Results: The MEs of all three plants have shown diuresis in normal rats. However, in intercomparison of the ME C. aromaticus (1,000 mg/kg p.o.) produced more signifi cant diuresis (P < 0.05) and electrolyte excretion compared to other test groups, the effect was at par with furosemide. The ME of these plants showed presence of alkaloids, glycosides, steroids, terpenoids, saponins, fl avonoids, etc. Conclusion: The ME of C. aromaticus (1,000 mg/kg p.o.) has showed highest diuretic action (4.2) among the tested extracts. This suggests the use of C. aromaticus leaves as “Pashanbhed”; the most effective diuretic drug.

A rare incidence of abnormally broad tendon of insertion of Tibialis anterior- A case report.

The objective of our study is to report a rare variation of insertion of tibialis anterior. It was fan shaped insertion on dorsal aspect of all the three cuneiforms, navicular and base of first metatarsal both on its medial and lateral side. The extension of the tendon on second and third cuneiforms has not yet been previously reported in literature. This communication and study of insertion of this muscle may be of importance to the orthopedicians since tibialis anterior is an important muscle because of its function and use in tendon transfer which is a common surgical procedure performed for the correction of paralytic equinovarus deformity of the foot, recurrent congenital clubfoot deformities in cerebral palsy and arthroscopy.

A cadaveric study of distance between the terminations of the hepato- pancreatic and accessory pancreatic ducts in the duodenal mucosa.

Objective: The present paper is about the study of distance between minor and major duodenal papillae which was carried out on 30 cadaveric specimens of human duodeno-pancreas. With introduction of ERCP, the pattern of pancreatic ductal system visualization has attained popularity. Without the knowledge of the normal pattern of the duct system and its variations, a radiologist can’t interpret an Endoscopic Retrograde Cholangio-Pancreatography (ERCP) picture. So it becomes important to study the anatomy of pancreatic ducts, their relation to each other, to common bile duct and to duodenum in the available human cadavers. To visualise and to see distance between minor and major duodenal papillae is necessary for the endoscopist who aims to perform the dilation, stenting, or papillotomy of the minor papilla. ERCP is proved to be “first line” therapeutic tool in the management of surgical, medical and pathological disorders involving the biliary tree and pancreatic duct. Methods: The study was conducted in thirty (20 male and 10 female) cadavers. Major and minor duodenal papillae were visualized through eosin dye installation in both common bile duct and the accessory pancreatic duct. The measurement of distance between the duodenal papillae was done in cm. Results: In the present work, the distance measured between the major and minor duodenal papilla was on an average 1.93+0.61 cm. in females and in males it was 2.05+0.31 cm. Conclusion: The length of the duct shows sexual dimorphism; the length being more in males than females.

Malaria genome project and its impact on the disease.

Malaria remains uncontrolled to-date due to lack of effective parasite and vector control strategies. With the completion of the host, parasite and vector genome projects more suitable and effective disease control measures can be achieved. Here we have reviewed the Plasmodium falciparum genome project and its impact on malaria research in future. The parasite genome project has revealed certain metabolic pathways which can be targeted to develop antimalarial drugs. It has also identified large number of potential antigens for the future potential vaccines. Now the researchers in the malaria field can plan to take up the studies, which can yield more fruitful results within the limited financial resources using bioinformatics, proteomics, structural, functional and comparative genomics, etc.