Mean Atd Angle among Type 2 Diabetes Mellitus Patients Visiting a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: An atd angle is one of the dermatoglyphic patterns which is an indication of the degree of distal displacement of the axial triradius on the palm. This is one of the markers of diabetes mellitus that is used as a screening tool in order to reduce the risk of onset and initiate early treatment. The aim of this study is to find the mean atd angle among type 2 diabetes mellitus patients visiting a tertiary care centre. Methods: This descriptive cross-sectional study was done among diabetic patients in a tertiary centre from 9 June 2021 to 5 May 2022. Ethical approval was taken from Institutional Review Committee (Reference number: KUSMS/IRC 40/2021). Both palm prints of study subjects were taken and the atd angle was measured. Convenience sampling was done. Point estimate and 95% confidence interval were calculated. Results: Among 133 palm prints of diabetic patients, the mean atd angle was 42.13±4.73° (male: 41.90±4.75° and female: 42.35±4.70°). The right palms showed mean atd angle of 42.31±4.42° and that of left palms was 41.94±5.04°. Conclusions: The mean atd angle among type 2 diabetes mellitus patients is similar to other studies done in similar settings. Keywords: dermatoglyphic; diabetes mellitus; prevalence.

Atypical Pattern of the Intrahepatic Biliary Duct on Magnetic Resonance Cholangiopancreatography in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: The liver possesses different patterns of intrahepatic duct confluences. Even though the typical pattern of the intrahepatic biliary duct is common, atypical variations are also frequently witnessed. The knowledge of the atypical intrahepatic biliary confluences is inevitable during hepato-biliary surgery to reduce post-operative complications. The aim of the study was to find out the prevalence of the atypical pattern of intrahepatic biliary duct pattern on magnetic resonanace cholangiopancreatography in a tertiary care centre. Methods: This descriptive cross-sectional study was done in a tertiary care centre after receiveing ethical approval from the Institutional Review Committee [Reference number: KUSMS/IRC (248/2021)]. The branching patterns of the atypical intrahepatic biliary pattern were observed in Magnetic resonance cholangiopancreatography images and were classified. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 199 magnetic resonance cholangiopancreatography images, the atypical intrahepatic biliary duct was observed in 48 (24.12%) (18.18-30.06, 95% Confidence Interval) of the images. Conclusions: The prevalence of the atypical intrahepatic biliary duct pattern is lower as compared to other studies done in similar settings. Keywords: bile ducts; liver; magnetic resonance cholangiopancreatography.

Variation and clinical significance of extensor pollicis brevis: a study in South Indian cadavers.

BACKGROUND: de Quervain's disease is a condition in which there is pain in the radial styloid process caused by stenosing tenosynovitis of the abductor pollicis longus (APL) or/and extensor pollicis brevis (EPB) tendons in the first extensor compartment of the wrist. In this study we studied variations in the tendons of the EPB in the first extensor compartment and its site of insertion. METHODS: One hundred fifty six upper limbs from adult cadavers of south Indian origin were dissected to observe the number of EPB tendons and the presence of an osseo-fibrous septum in the first extensor compartment of the wrist. RESULTS: The EPB had a single tendon in 133 limbs, double tendons in 17 limbs and triple tendons in only 6 limbs. The EPB was present in all of the upper limbs in our study. In 34.6% of cases, the tendons of the EPB were separated from the tendons of APL by an osseo-fibrous septum in the first extensor compartment. CONCLUSION: Variation in the number of EPB tendons and site of insertion should be taken into consideration by clinicians and surgeons when performing surgical decompression of the first extensor compartment of the wrist in de Quervain's syndrome. Surgical failure may occur due to overlooking variations in EPB tendons or septation of the first extensor compartment.

The morphology of meningo-orbital foramen in south Indian population.

When present, the meningo-orbital foramen forms an additional link between the orbit and the middle cranial fossa. It contains an arterial anastomose between the middle menigeal artery--the meningo-lacrimal branch and the lacrimal artery--the meningeal branch. The incidence of this foramen is known to vary between 28-82.9%. In the present study of 138 dry adult skulls of South Indian origin, the meningo-orbital foramen was present in 80.4% of population. The mean distance of the meningo-orbital foramen from the supra-orbital notch was 34.14 mm (29-38 mm) and from the fronto-zygomatic suture it was 26.10 mm (28-35 mm). The incidence and location of the meningo-orbital foramen may be of surgical significance to ophthalmologists (Tab. 1, Fig. 3, Ref. 7).

An unusual course and entrapment of the lingual nerve in the infratemporal fossa.

The infratemporal fossa is one of the most difficult regions of skull base to access surgically. The presence of the ossified pterygospinous and pterygoalar ligaments makes it more critical and difficult to access, with an occasional entrapment of structures like the mandibular nerve (MN) and its branches. During a routine dissection of an adult male cadaver, an unusual course of the lingual nerve (LN) was found with an entrapment of the nerve between the ossified pterygospinous ligament and the medial pterygoid muscle. Furthermore, all the three branches of the posterior division of the mandibular nerve communicated with each other by two anastomosing branches. The clinical significance of the present variations has been discussed (Fig. 1, Ref. 23).