Morphometry of Posterior Cruciate Ligament in Knee joint - A Cadaveric Study.

Objectives: Surgical repair of severely injured posterior cruciate ligament is mandatory. Therefore, the anatomical features of the PCL and its two bundles description help to define the appropriate size of the allograft for excellent results in reconstruction surgeries. Material and methods: Fifty knees were dissected from twenty-five fresh human cadavers (15 male and 10 female) of donors used for teaching purpose. The length and footprint area of PCL and patellar tendon length were measured, and determined the range of normality according to sex and height. Results: The average lengths of the PCL's Antero-medial (AM) and posterolateral (PL) bundle were 35. 52 ± 0.66 mm and 32.76 ± 0.64mm, respectively in male and 35.37 ± 0.07 & 32.58 ± 0.61mm in female. The femoral footprint of PCL was 133.10 ± 0.7 mm2 in male and 133.05 ± 0.7 mm2 in female observed, while the tibial footprint 132.21± 1.02 mm2 in male and 132.42 ± 0.8 mm2 in female was observed. Conclusion: The AM and PL bundle lengths were higher in males than females. There was a strong correlation between height and length of ligaments but no correlation with age.

Morphometry of depth of interhemispheric fissure on Indian cadaveric brain specimens.

Background: During neurosurgeries like resection of interhemispheric lipoma or cyst, surgeon needs to remain within the limits of interhemispheric fissure (IHF). Despite a massive literature search, data regarding the morphometry of IHF is meagre. Therefore, the present study was done to calculate the depth of IHF. Materials and Methods: Twenty-five (fourteen male and eleven female) fresh human cadaveric brain specimens were used. The depth of IHF was measured from frontal pole; three points, anterior to coronal suture (A, B and C); four points, posterior to coronal suture (D, E, F and G) and from two points (via parieto-occipital sulcus and calcarine sulcus) on occipital pole. The measurements were taken from these points up to the floor of IHF. IHF is a midline groove and hence the measurements were taken from each point against both the left and the right cerebral hemispheres. At the end, not much bilateral asymmetry was found, hence the average of the reading for the same point against left and the right cerebral hemisphere was considered for calculation. Result: Maximum depth was found to be 59.60 mm and minimum depth was found to be 19.66 mm among all the points which were considered for evaluation. No statistical difference was found in the depth of IHF among the male and the female groups as well as in the various age groups. Conclusion: This data and knowledge about the depth of interhemispheric fissure will aid the neurosurgeons in order to perform the interhemispheric transcallosal approach as well as surgeries of interhemispheric fissure such as excision of lipoma, cyst, tumor of interhemispheric fissure through the shortest and the safest possible route.

Morphometry of Anterior Cruciate Ligament in Knee joint. A Cadaveric Study.

Objectives: The journey of Anterior Cruciate Ligament (ACL) reconstruction surgery has long way from open surgery to arthroscopy. Therefore, the anatomical features of the ACL and its two bundles description rewarded as good outcome of procedure. Material and methods: Fifty fresh knees were dissected. The insertion position, length and diameter of ACL and patellar tendon length were measured and determines the range of normality according to sex and side. Results: The average lengths of Antero- medial (AM) and postero- lateral (PL) bundle of the ACL were 35.35 mm and 26.11mm in male on right side, respectively while 34.21mm and 25.53 mm in female. Patellar tendon length was 45.24 mm in right side of male and 43.38 mm in female obtained. The average lengths of AM and PL bundle of the ACL were 35.47 mm and 26.04 mm in male on left side, respectively while 34.23 mm and 25.38 mm in female. Conclusion: The length of ligaments was higher in male than female. There was strong correlation between height and length of ligaments but no correlation with age.

Anatomical Variations of Corona Mortis in the Anterior Intrapelvic Approach: A Cadaveric Study.

Corona mortis (CMOR) is an anastomotic channel either arterial, venous or both connecting the obturator and external iliac systems excluding aberrant channels in the retropubic space. The goal of this study is to illustrate the type of CMOR via the Anterior Intrapelvic approach (AIP) which has not been studied in tandem. This descriptive observational study was performed in the Department of Anatomy, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India from January 2018 to December 2020. It is a potential culprit for significant haemorrhage in scenarios of pelvic trauma or when sectioned accidentally, augmenting difficult haemostasis behind the superior pubic ramus. Previously reported to be exclusively arterial, the venous variant has now emerged as the more frequent anastomosis. AIP was performed on 31 adult human cadavers of 62 hemipelvises to record variations and statistical analysis of retropubic anastomosis with respect to gender, weight groups and side distribution was done. Corona Mortis was observed in 50(80.6%) hemipelvises. To ramify, venous CMOR and arterial CMOR were exclusively encountered in 25(40.3%) and 10(16.10%) hemipelvises respectively. Males recorded a higher prevalence of CMOR. Despite being a frequent anastomotic variant, it is a rare entity in textbooks. CMOR can potentially alter patient outcome and have serious implications in pelvic surgeries via AIP owing to its easier accessibility. Besides, venous CMOR being more common, a venous bleed is inherently more arduous to manage in the pelvis. A larger calibre, less frequent aberrant channel could also prove to be lethal in its injury. Hence, cadaveric simulation of the technique is paramount to master the technique and to mitigate catastrophic vascular events.

Tibio-femoral Angle Assessment and Its Radiological Co-relation in Healthy Rajasthani Population.

Existence of variations in morphological proportions in human beings has led to the development of different values of tibio femoral angle (TFA) in different populations which is undoubtedly useful in clinical orthopaedic surgery. Meagre literature is available among Indian population. The cross-sectional study was creating baseline data of TFA among Rajasthani population of India with reasonable accuracy and also to correlate these data to radiological findings during July 2014-June 2016. The TFA (in degrees) of 500 healthy subjects from various regions of Rajasthan were measured in standing and supine positions. In addition, the TFA of 134 persons (randomly selected) from study group were also measured on roentgenogram. Subsequently both of these data were compared. The normal range of TFA angle in Rajasthani population was in between 160°-174°. TFA in standing position on right side was 170.96° (with 95% Confidence Interval (CI) = 170.24 to 171.68) and on left side was 170.14° (with 95% CI = 169.21 to 171.06). Mean TFA in supine position on right side in age group from 21 to 30 years was 167.12±6.73° and in age group from 31-40 years was 167.668±6.7°. No significant difference was observed in posture change and according to age. Statistically significant difference was observed in between radiological and gross measurement which was more in radiological than to clinical measurement of TFA (mean difference = +5.78° units) with 95% CI for the difference is (4.03°-7.53°). Higher values of tibio-femoral angle (TFA) were observed in males as compared to females and in radiological measurements.

Sex Determination in Western Indian Population by Limb Measurements.

For individual identification, the principal biological element is sex determination from disfigured and amputated limbs or body fragments in forensic investigation. Diverse dimensions and proportions affect the anthropometric assessment of sex in different populations. A cross-sectional study was conducted during July 2014 to June 2016 on five hundred and four healthy individuals of age-group 22-40 years of Western India to see the degree of sexual dimorphism in limb measurements. The forearm length, whole upper limb length, tibial length and whole lower limb length of both sides were measured by the universal anthropometric criteria. Demarking points, sexual dimorphism indices and discriminant functions were developed for each measurement. The sexual dimorphism was observed in all variables and males have a higher value than females (p<0.001). The tibial length showed the highest accuracy in sex determination and the highest sexual dimorphism, followed by whole lower limb length. The range of Cross-validated sex classification precision was between 58-90% for the individual variables, 91.7% for the stepwise method and 95.4% for all measurements taken together. The established prototypes delivered effective and consistent sex estimates with high precision rates and low prediction errors.

Carrying Angle in Population of Western India: Normative Values.

Carrying angle is one of the secondary sexual characteristics which is important for keeping the hand away from body to improve functionality. A cross-sectional survey was conducted in Western Indian population (rural and urban population in and around Jodhpur district) during July 2014-June 2016 with the purpose of evaluating the carrying angle in apparently healthy adult and determines the range of normality according to age, sex, height, waist circumference and special reference to handedness. The carrying angle (elbow) was measured in 504 adults aged between 20-40 years (by simple random sampling) by a digital Goniometer. The subjects were in anatomical position (stand up straight, roll his/her shoulders back and the elbow was fully extended and the forearm fully supinated) while the carrying angle were taken. Carrying angle of the right side in male's 11.54°±1.29° and in female's 13.41°±1.26°, whereas these value in left side 10.21°±1.34° and 12.19°±1.44° respectively. All measurements in females are significantly higher in comparison to males (p<0.001). The significant difference was observed in carrying angle according to handedness; dominant hand had higher value of carrying angle in comparison to non-dominant hand in both gender (p<0.001). The height of individuals is positively correlated with the angle whereas there was no correlation was found in between age, waist circumference. The present study showed that the females have greater carrying angle than males.

Manifestaciones orales y disfunción olfativa y gustativa en el síndrome respiratorio agudo severo por corona virus 2 (VIRUS SARS-COV-2): una revisión sistemáticaA / Oral Manifestations and Olfactory and Gustatory Dysfunction in Severe Acute Respiratory Syndrome Corona Virus 2 (SARSCov-2 Virus) Disease: A Systematic Review

La enfermedad del corona virus 2 del síndrome respiratorio agudo severo (virus SARS-CoV-2) apareció por primera vez en diciembre de 2019 en Wuhan, China, y desde entonces se ha extendido rápidamente por todo el mundo. Desde entonces, el brote de esta grave enfermedad viral se ha convertido en una amenaza global para la humanidad. El diagnóstico precoz y el aislamiento son las medidas más importantes necesarias para prevenir su propagación. La evidencia anecdótica reciente ha sugerido manifestaciones orales con o sin deterioro olfativo y gustativo en asociación con la enfermedad por coronavirus (COVID-19). La enzima convertidora de angiotensina-2 (ECA-2) se expresa en la mucosa oral en grandes cantidades y, por tanto, puede contribuir a las primeras manifestaciones de esta enfermedad viral mortal. Las manifestaciones bucales de la enfermedad por coronavirus pueden presentarse en forma de lesiones ulcerativas irregulares en relación con diferentes partes de la cavidad oral y, en particular, en relación con la mucosa adherida en la región del paladar duro, así como inflamación y posterior atrofia de las diversas papilas de la lengua. La disfunción olfativa y gustativa asociada también puede conducir a una pérdida parcial y / o incluso completa de la capacidad para oler y saborear en las primeras etapas del inicio de la enfermedad. La evidencia también ha sugerido la presencia de ácido nucleico del SARS-CoV-2 en la saliva humana, lo que la convierte en portadora de la enfermedad viral infecciosa y ayuda en su diagnóstico. Hemos buscado sistemáticamente la base de datos médica para el mismo y hemos revisado toda la literatura disponible hasta el 29 de junio de 2020

Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2 virus) disease had first appeared in December 2019 in Wuhan, China and has been spreading quickly throughout the world since then. Since then, the outbreak of this severe viral disease has become a global threat to humanity. An early diagnosis and isolation are the most significant measures required to prevent its spread. Recent anecdotal evidence has suggested oral manifestations with or, without olfactory and gustatory impairment in association with corona virus disease (COVID-19). Angiotensin converting enzyme-2 (ACE-2) is expressed in oral mucosa in large amounts and can, thus, contribute in the early manifestations of this deadly viral disease. The oral manifestations of corona virus disease can occur in the form of irregular ulcerative lesions in relation to different parts of the oral cavity and particularly, in relation to the attached mucosa in the hard palate region as well as inflammation and subsequent, atrophy of the various tongue papilla. The associated olfactory and gustatory dysfunction can, also, lead to partial and/or, even a complete loss of the ability to smell and taste in the early stages of the disease onset. Evidence has, also, suggested the presence of SARS-CoV-2 nucleic acid in human saliva making it the carrier of the infectious viral disease as well as aiding in its diagnosis. We have systemically searched medical database for the same and have reviewed all the literature available up to 29th of June 2020.

Stature Estimation from Measurements of Inferior Extremity in Different Stature Groups of Western Indian Population.

Growth and stature of individuals depend upon various factors like environment, race, and inheritance etc. India has different ethnic groups, which are unique in their genetic and socio economic status. Therefore, present study is formulated to estimate the stature by four anthropometric measurements of the inferior extremity in the Western Indian population (rural and urban population in and around Jodhpur district) during July 2014-June 2016 and to compare with other regions of India with respect to body proportion used for stature estimation equations. Measurements of lower limb length and tibial length on both side, and in both genders of 504 individuals were done. Stature estimation equations were developed by single and multiple predictor models and compared with previous researches. Four subgroups were also made according to the stature to see the hypothesis that body proportions will vary in short, medium and tall individuals. A positive correlation (Pearson's) was observed between stature and all the four measurements of inferior extremity. The strongest correlations observed were between lower limb length and stature for all groups (combined r=0.991; males r=0.971; females r=0.967). The highest estimation accuracy (R²=0.992, SEE=0.718) was observed in male during height estimation done by measurements of left side as suggested by low SEE value. Strong correlation in between stature and other body proportions was observed in taller group of individuals either male or female. Significant difference in all the regions was observed, when compared with previous research and suggests that western Indians are peculiar in their body proportions. It was also detected that body proportion may vary according to the stature.

Estimation of Stature from Measurements of Superior Extremity in Western India.

As India has diverse environmental conditions in her regions, the different environmental condition must affect the growth and development of an individual may also affect the height achieved at adulthood. Total 504 volunteers of Western India were recruited in the study. Stature estimation equations were developed by single and multiple predictor models. Stature calculated in the present study was compared with earlier researchers. Evaluated with Pearson's correlation analysis all the eight measurements (Length of superior extremity, forearm and hand and breadth of hand on both sides) were positively correlated with stature. The strongest correlations were observed between superior extremity length and stature for all groups (combined r=0.886; males r=0.871; females r=0.950). Left superior extremity length had the lowest Standard error of estimation (SEE) for all groups (combined ±3.63cm; males ±2.736cm; females ±1.045cm) and coefficient of determination (R²) for the combined, males and female groups (78.6%, 76.1%, and 90.4% respectively) in single predictor linear regression model equation. In multiple regression model the highest accuracy (R²=0.908, SEE=1.381) was observed in the female when hand length and superior extremity length of the left side were used. Coefficients of determination (R²) obtained in this study were more than 70% in all the estimates except where hand breadth was involved. Predicted stature could be more accurate among females as compared to male. By single prediction model using superior extremity length was able to give the most accurate height, whereas, the accuracy improved as the number of predictors increased.

Morphometric evaluation of Anterior Cerebral Artery (on Digital Subtraction Angiography)-Potential implications.

PURPOSE: The aim of the present study was to perform a morphometric analysis of ACA and to establish significant differences, if any, with sex and age via Digital Subtraction Angiography (DSA). METHODS: This cross-sectional study was conducted on 70 patients (>20 years) for the evaluation of ACA by Digital Subtraction Angiography done on a Philips biplane system clarity (Allura FD20/20). Length and diameter of ACA were taken manually on the DSA console using auto-calibration. Statistical analysis was done. RESULT: Mean diameter and length of ACA was found to be greater in female. The f-ratio value for diameter and length of the same was 1.43 and 0.92 respectively. The length of ACA was found to be statistically significant for different age groups. The mean length of ACA followed a decreasing trend with age, whereas mean diameter of ACA was nearly the same in all the age groups. CONCLUSION: The results of our study show that the length of ACA was found to be statistically significant for different age groups.

Genetically Encoding Photocaged Quinone Methide to Multitarget Protein Residues Covalently in Vivo.

Genetically introducing covalent bonds into proteins in vivo with residue specificity is affording innovative ways for protein research and engineering, yet latent bioreactive unnatural amino acids (Uaas) genetically encoded to date react with one to few natural residues only, limiting the variety of proteins and the scope of applications amenable to this technology. Here we report the genetic encoding of (2 R)-2-amino-3-fluoro-3-(4-((2-nitrobenzyl)oxy) phenyl) propanoic acid (FnbY) in Escherichia coli and mammalian cells. Upon photoactivation, FnbY generated a reactive quinone methide (QM), which selectively reacted with nine natural amino acid residues placed in proximity in proteins directly in live cells. In addition to Cys, Lys, His, and Tyr, photoactivated FnbY also reacted with Trp, Met, Arg, Asn, and Gln, which are inaccessible with existing latent bioreactive Uaas. FnbY thus dramatically expanded the number of residues for covalent targeting in vivo. QM has longer half-life than the intermediates of conventional photo-cross-linking Uaas, and FnbY exhibited cross-linking efficiency higher than p-azido-phenylalanine. The photoactivatable and multitargeting reactivity of FnbY with selectivity toward nucleophilic residues will be valuable for addressing diverse proteins and broadening the scope of applications through exploiting covalent bonding in vivo for chemical biology, biotherapeutics, and protein engineering.

Morphometry and variations of the human suprascapular notch.

AIM: The present study proposes a simple method to study variations in shape and dimensions of suprascapular notch, to classify different types and subtypes of notch and to measure the thickness of superior transverse scapular bar (ossified superior transverse ligament of scapula). MATERIAL AND METHODS: Seven hundred and twenty-eight dried scapulae were observed, examined and studied in detail. Scapulae with suprascapular notch, with suprascapular foramen having varying degree of ossification in the form of transverse scapular bar were included in the present study. Measurements of suprascapular notch and superior transverse scapular bar were taken with the help of digital vernier calliper and recorded in millimetres. The superior transverse diameter, inferior transverse diameter, depth, maximum thickness of suprascapular notch and thickness at lateral and medial end of transverse scapular bar, mean thickness of superior transverse scapular bar were recorded. The data was analyzed statistically. OBSERVATIONS AND RESULTS: We observed five types of notch in scapulae, type I: without a discrete notch (ill defined), 25 (3.43%); type II: a "V" shaped notch, 192 (26.37%); type III: "U" shaped notch, 383 (52.60%); type IV: inverted "V" shaped notch, 28 (3.84%); type V with absent suprascapular notch: 6 (0.82%). Type II and type III were again subclassified into subtypes (a, b, c and d) on the basis of depth of notch. Scapulae with superior transverse scapular bar (n=94, 12.91%) were classified according to variation in mean thickness of transverse scapular bar (MTSB). CONCLUSION: This study will help clinicians to correlate suprascapular nerve entrapment with a specific type of suprascapular notch and notch with ossified transverse scapular ligament.

Morphometric analysis and anatomical variations of infraorbital foramen: a study in adult North Indian population.

PURPOSE: Various studies have been conducted on morphometric variations of infraorbital foramen to provide data to surgeons for nerve block in infraorbital region. This study aims to analyse the anatomical variations by comparing various morphometric measurements of infraorbital foramen in dry skulls of adult North Indian population. This study becomes relevant in the present study group as very scant data is available about the variations and morphometric measurements in Indian population. The data thus collected can be standardized and become useful for the surgeons working in this area of face. MATERIALS AND METHODS: The study was conducted on 75 dry adult human skulls, which were a part of Department of Anatomy, used for teaching purposes in medical colleges. Straight distance of the Infraorbital foramen from the infraorbital rim, supraorbital foramen and sagittal plane was measured. The position of the infraorbital foramen was determined in relation to maxillary teeth and supraorbital foramen. The data thus obtained was analysed. RESULTS: The distance of infraorbital foramen from infraorbital rim, supraorbital foramen, sagittal plane in the present study was found to be 6.71 ± 1.11 mm, 42.02 ± 4.31 mm and 31.94 ± 4.88 mm respectively. The position of infraorbital foramen was lateral in relation to supraorbital foramen (in 88% of cases). Infraorbital foramen was above the 1st premolar tooth in most of the cases. Accessory infraorbital foramen was found in 11.2% cases (double foramen). CONCLUSION: The data thus obtained will perhaps be helpful to the surgeons in identifying the extent of the operative field thereby reducing procedural risks.

Regulatory dendritic cell expression of MHCII and IL-10 are jointly requisite for induction of tolerance in a murine model of OVA-asthma.

BACKGROUND: Allergen-presenting dendritic cells differentiated with IL-10 (DC10) reverse the asthma phenotype in mice by converting their Th2 cells to regulatory T cells (Tregs). DC10 express elevated levels of IL-10, but substantially reduced levels of MHCII and costimulatory molecules, so the relationships between these factors with each other and tolerogenicity have not been clearly elucidated. METHODS: We assessed the roles of these inputs in DC10 reversal of OVA-associated asthma-like disease by treating affected mice with OVA-pulsed DC10 generated from wild-type or IL-10-sufficient MHCII(-/-) or CD80/CD86(-/-) mice, or with MHCII-intact IL-10-silenced DC10. RESULTS: IL-10 silencing did not discernibly affect the cells' immunobiology (e.g., costimulatory molecules, chemokines), but it eliminated IL-10 secretion and the cell's abilities to induce tolerance, as determined by assessments of airway hyper-responsiveness, eosinophilia, and Th2 responses to recall OVA challenge. MHCII(-/-) DC10 expressed normal levels of IL-10, but, nevertheless, were unable to induce allergen tolerance in asthma phenotype mice, while tolerance induced by CD80/CD86(-/-) DC10 was attenuated but not eliminated. We also assessed the induction of multiple Treg cell markers (e.g., ICOS, PD-1, GITR) on pulmonary CD25(+) Foxp3(+) cells in the treated mice. Wild-type DC10 treatments upregulated expression of each marker, while neither IL-10-silenced nor MHCII(-/-) DC10 did so, and the CD80/86(-/-) DC10 induced an intermediate Treg cell activation phenotype. CONCLUSION: Both IL-10 and MCHII expression by DC10 are requisite, but not sufficient for tolerance induction, suggesting that DC10 and Th2 effector T cells must be brought together in a cognate fashion in order for their IL-10 to induce tolerance.

Intrathoracic intrusion of left lobe of thyroid gland co-existent with absent isthmus: clinico-anatomical considerations.

BACKGROUND: Morphological alterations of thyroid gland are common and result because of disturbed embryogenesis. These may vary from hypoplasia, ectopy to hemiagenesis and genesis of the gland. The authors strive to report an unusual morphological alteration of the left lobe of the thyroid gland. The current study presents a case of unusual extension of the thyroid gland discovered incidentally while dissecting the anterior cervical region of an adult Indian male cadaver. The left lobe displayed medial extension from its inferior angle which overlapped the common carotid artery (CCA). The isthmus was absent; instead a fibrous strand was interposed in between the two lobes with ramification into both the lobes. The relevance of diagnosing such extensions of thyroid gland is immense. It may alter the topographical relationship of thyroid gland with other adjacent cervical structures. Further, it may present abnormal signals upon scintillation scans and may be confused with a tumor mass on MRI scans. Lastly, the presence of lobar extension along with absence of isthmus is a gross morphological variant and in our opinion not to be overlooked by anatomists, ultrasonologists as well as thyroid surgeons. Additionally, the study presents possible embryological explanation for these gross anatomical variations.

Unusual architecture of extensor digitorum muscle of hand in conjunction with accessory belly of extensor carpi radialis brevis: a clinico-anatomical insight.

The present article highlights an unusual combination of variations of the extensor digitorum and extensor carpi radialis brevis muscles in the dorsum of forearm and hand. The extensor carpi radialis brevis exhibited an accessory musculotendinous belly which inserted into the dorsal digital expansion of index finger. The extensor digitorum showed trifurcation into three distinct parts. Resultant multiple extensor tendon insertion pattern is reported upon highlighting the embryological basis and clinical importance. Knowledge of such anatomical variations adds upon the already existing information in literature and is also of profound interest to the clinician. Anatomical awareness of accessory multiple extensor tendons in the dorsum of hand is essential for successful management of extensor tendon injuries and graft transfer operations.

Anomalous disposition of profunda femoris artery: a clinicoanatomical appraisal.

During educational dissection of the left lower limb of an adult Indian male cadaver, an unusual variation of the branches of the femoral artery and profunda femoris artery (PFA), were observed. The profunda femoris artery and medial circumflex femoral artery took origin from a common arterial trunk from the medial side of femoral artery. The PFA coursed lateral to the femoral vein. The lateral circumflex femoral artery (LCFA) took origin, 1.2 cm proximal to the origin of the latter. The lateral circumflex femoral artery (LCFA) took origin directly from the femoral artery. The femoral vein was constantly medial to the PFA and coursed between it and femoral artery. The great saphenous vein was observed to course medial to the PFA and at its termination coursed anterior to the latter to drain into the femoral vein. Changes in caliber of femoral artery were recorded at the site of origin of the variant branches.

An atypical composition of adductor hallucis co-existent with an accessory plantar muscle and duplication of flexor digiti minimi pedis.

Adductor hallucis (AH) is frequently employed in transposition onto the first metatarsal head to alleviate symptoms of hallux valgus. Although tis muscle receives sufficient anatomical description, it is often disregarded in clinical practice. The rare anomalies associated with AH, merit a detailed study owing to its contribution to the treatment of hallux valgus. Additionally, the AH may be employed in plastic and reconstructive surgeries as a graft to cover defects of the foot. Therefore, we sought to report this infrequent anomaly relating to the AH muscle. Through the course of a regular educational gross anatomy class a muscular variant of the plantar musculature was noticed. A meticulous dissection was carried out and the specimen photographed. The oblique head of AH displayed three bellies whereas the transverse head was unremarkable. Another accessory belly was observed taking origin from the fourth metatarsal bone. Additionally, the flexor digiti minimi brevis (FDMB) displayed two bellies medial and lateral. A preoperative radiological assessment of the foot to be operated upon may provide the necessary information and may detect these muscular anomalies. Utilizing these variations to their benefit during operation will shorten the procedure time and may reduce post-operative risks and complications. We report this unique muscular anomaly to alert the foot surgeons and radiologists and plan their procedures accordingly.

Unusual grooved styloid process in a human skull: morphological details and clinical implications.

The temporal Styloid Process is an important anatomical landmark for surgeons while performing skull based surgery, for anaesthetists while injecting local anaesthetic solution and for radiologists during interpretation of CT and MRI scans. Knowledge of morphological variations of the styloid process such as a unique groove on its posterior aspect as seen in the present case not only has great clinical implications but is also of academic interest. The present article describes in detail an unusual groove in the styloid process with an additional anterior angulation at its tip. The morphological features, embryological basis and clinical relevance is discussed in details.