Insights with consensus on Abductor Pollicis Longus from the Central Indian population at Nagpur, Maharashtra.

The anatomical snuff box is bounded laterally by the Abductor pollicis longus (APL) and the Extensor pollicis brevis (EPB) tendons. The variation in insertion of extensor tendons at the forearm and wrist is an interesting phenomenon. Therefore, a sound knowledge of such variations in extensor tendons is essential to know the consequence of tendon injury during implementation of its repair. Hence, we studied 48 formaldehyde fixed forearms of Indian-origin cadavers with age groups ranging from 33 to 67 years from the Central Indian population at Nagpur, Maharashtra, India. Variation in the insertion of APL was checked by tracing the tendon till its insertion. APL muscle was found with single tendon in 20 forearms, double in 9, triple in 8 and quadruple in 5 and five (maximum) in 6 forearms. In 93% (n=45), the APL tendon was inserted into the first metacarpal bone and in 7% (n=03), it was inserted into the trapezium bone. No variation was noted in the EPB tendon. Data shows that there are accessory slips in the APL tendon, differing from the standard description. Thus, data provides awareness of such potential variation among operating surgeons for better management of the diseased during dissection.

Effectiveness of an Innovative Card Game as a Supplement for Teaching Factual Content to Medical Students: A Mixed Method Study.

Introduction Lectures and small group teaching are useful to transfer conceptual knowledge. Anatomy is the foundation of medical sciences, but it is perceived to be difficult to comprehend and recall. For such clinically relevant aspects of medical education that require memorization, educational card games can be very effective. As the complex concepts and terminology of Embryology are difficult to follow and retain, we designed a card game "MedFc" for a topic on pharyngeal arches. This study was planned to determine the effectiveness of the card game on curriculum comprehension, recall of factual topics among medical undergraduates, and its utility as a supplement to interactive lecture sessions. Methods The mixed method study was conducted in the Department of Anatomy of an undergraduate medical college. Ethical approval was obtained prior to beginning the study. Convenience sampling was done. From a batch of 50 first-year medical students, a total of 40 students consented to participate in the study, 24 (60%) were males and 16 (40%) were female participants. A lecture on the pharyngeal arches was conducted for the entire batch of 50 first-year medical students. After three weeks, the students who consented to participate in the study were randomly grouped into two groups of 20 each. The groups were the game group (which played the card game in teams of five) and the control group (which discussed the same topic in small groups of five). For both the group's pretests and posttests, 10 higher order multiple choice questions, were conducted and students' feedback regarding the effectiveness of the teaching technique was obtained. Results Students opined that playing the card game was a superb experience, a positive use of time, and a very effective method of comprehension and memorizing complex topics. The scores increased from the pretest to the posttest indicating that both methods effectively reinforced the embryological concepts, but a t test showed that card game is more effective than small group discussions, with p-value = 0.008. The improvement in scores of students who had achieved <50% in pretest for the game group was statistically significant with t-value = 0.0023, when compared with the improvement in scores of similar students from the control group. Conclusions The study has demonstrated the effectiveness of "MedFc" card game in the recall of factual topics and can be used as supplementary material for enhancing learning amongst medical graduates. This educational card game applies gamification to Anatomy education to create a fun filled learning experience and is a valuable addition to the learning resources.

The Role of the Flipped Classroom Method in Short-Term and Long-Term Retention Among Undergraduate Medical Students of Anatomy.

Introduction Medical education is changing towards more flexible, effective, active, and student-centred teaching strategies that reduce the limitations of traditional methods of education. Recently, the flipped classroom method has been suggested to support this transition. However, research on the use of flipped classroom methods in medical education pertaining to short- and long-term retention of the topics is at an early stage. The present paper aims to determine and compare the effects of traditional and flipped classroom methods on first-year medical students' short-term and long-term retention. Method Fifty first-year medical students were subjected to traditional and flipped classroom modules in the form of five sessions each on gross anatomy topics of the thoracic region. These sessions were conducted during independent teaching slots for anatomy. Assessments were done at the completion of each module for both methods. Then, after a gap of two months, the students were again assessed on the content taught in the modules as a part of formative assessment. The data so obtained were compared and analysed statistically. Ethical approval was obtained prior to beginning the study. Written informed consent was obtained from the participating students. Result A total of 50 first-year medical students participated in the study. 33 (67%) participants were males, with a median age of 19.47 years, and 17 (33%) participants were females, with a median age of 19.39 years. The assessment scores showed differences between the two methods of teaching in the short and long term. The flipped classroom method was observed to have significant short-term retention with a p-value <0.0001, which is statistically significant. Conclusion The study concludes that the flipped classroom method serves as an advantageous tool and motivating factor for effective learning, understanding, and retention of conceptual and factual anatomical content.

Molecular docking analysis of glycogen phosphorylase with inhibitors from Cissampelos pareira Linn.

Cissampelos pareira Linn. is a climbing herb known in Indian traditional medicine as laghupatha. It belongs to the Menispermaceae family. The enzyme glycogen phosphorylase (GP) is a promising target for the treatment of type-2 diabetes (T2DM). A variety of natural product inhibitors with both pharmaceutical and nutraceutical potential have been reported in the search for powerful, selective and drug-like GP inhibitors that could lead to hypoglycemic medicines. Therefore, it is of interest to document the molecular docking analysis data of glycogen phosphorylase with compounds from Cissampelos pareira Linn. We report the optimal binding features of 4 compounds namely Trans-N-feruloyltyramine, Coclaurine, Magnoflorine, and Curine with the target protein for further consideration in the context of T2DM.

Molecular docking analysis of PARγ with compounds from Ocimum tenuiflorum.

The ligand-activated transcription factor peroxisome proliferator-activated receptor (PPAR) has become a major target for type 2 diabetes. It belongs to the nuclear receptor superfamily, which controls the expression of proteins involved in glucose metabolism, lipid metabolism, adipocyte proliferation and differentiation, and insulin sensitivity. Ocimum tenuiflorum, often known as Krishna tulsi, is the most sacred herb in India. It was utilized for a variety of medicinal purposes. Therefore, it is of interest to document the molecular docking analysis data of PARγ modulators from Ocimum tenuiflorum. Four of the twenty substances (rosmarinic acid, permethrin, luteolin, and isosakuranetin) have a considerable binding affinity for the PPARγ. These phytochemicals are a source of potential anti-diabetic medicines.

Partial Duplication of the Left Ureter and Enlarged Left Suprarenal Gland - A Case Report.

During routine dissection classes for the first-year undergraduate medical students, we encountered an anatomical variation concerning the duplication of the ureter. Usually, a single ureter connects to the posterior renal hilum. In the present case, a double ureter arises from the hilum on the left side and an enlarged suprarenal gland. The accessory ureter travels a short distance from the hilum before joining the other ureter. These anomalies are becoming more common during renal surgeries and renal transplant surgeries. Damage to the accessory ureter may result in complications following surgery. Knowledge of an accessory ureter and an enlarged suprarenal gland is clinically important for renal surgeons, radiologists, and anatomists.

Sex hormones and COVID-19: tussle between the two.

Novel coronavirus disease (COVID-19) has affected nearly 7 million individuals and claimed more than 0.4 million lives to date. There are several reports of gender differences related to infection and death due to COVID-19. This raises important questions such as "Whether there are differences based on gender in risk and severity of infection or mortality rate?" and "What are the biological explanation and mechanisms underlying these differences?" Emerging evidences have proposed sex-based immunological, genetic, and hormonal differences to explain this ambiguity. Besides biological differences, women have also faced social inequities and economic hardships due to this pandemic. Several recent studies have shown that independent of age males are at higher risk for severity and mortality in COVID-19 patients. Although susceptibility to SARS-CoV-2 was found to be similar across both genders in several disease cohorts, a disproportionate death ratio in men can be partly explained by the higher burden of pre-existing diseases and occupational exposures among men. At immunological point of view, females can engage a more active immune response, which may protect them and counter infectious diseases as compared to men. This attribute of better immune responses towards pathogens is thought to be due to high estrogen levels in females. Here we review the current knowledge about sex differences in susceptibility, the severity of infection and mortality, host immune responses, and the role of sex hormones in COVID-19 disease.

Oxidative stress and its impact on mitochondrial DNA in pulmonary tuberculosis patients- a pilot study.

BACKGROUND: Pulmonary tuberculosis (PTB) remains a major cause of morbidity and mortality all around the world. Recent studies have pointed out increased oxidative stress and also DNA damage in peripheral blood in PTB. Till date, to the best of our knowledge, no study has so far been conducted to show the mitochondrial DNA (mtDNA) deletions mapping in PTB patients. Therefore we performed the present study with the aim to investigate oxidative stress parameters along with mtDNA damage in newly diagnosed untreated PTB patients. MATERIAL AND METHODS: This is a prospective study carried out in Mahatma Gandhi Institute of Medical Sciences, Sevagram,Wardha, Maharashtra during september 2017 to september 2018.Thirty newly diagnosed untreated PTB patients and thirty age matched healthy controls were enrolled in the present study. Analysis of Oxidative stress parameters such as nitric oxide (NO) and malondialdehyde (MDA) were done by calorimetric methods. Assessment of mitochondrial DNA damage was carried out by mtDNA deletions mapping using primer shift long range polymerase chain reaction technique. RESULTS: There was significant increase in levels of oxidative stress parameters, nitric oxide and malondialdehyde, in PTB patients compared to controls (p < 0.01). Generally there are two common deletion sites of "13 bp direct repeats" (ACCTCCCTCACCA) in mtDNA. One at the junction sites from bp 8470 to 8482 bp and another from bp 13447 to 13460 bp which make mtDNA more prone for 4977bp deletion. Out of thirty cases of PTB, two cases showed mtDNA damage in the form of mtDNA deletion of 4977bp. There was no mtDNA deletion in any control which can be attributed to continuous generation of oxidative stress. CONCLUSION: This pilot study has been able to demonstrate that compared to controls, in newly diagnosed pulmonary tuberculosis patients some mtDNA damage did occur and was probably due to continuous generation of oxidative stress in tuberculous patients. However, sample size is too small to draw any conclusions but definitely a more comprehensive study, by recruiting more number of pulmonary tuberculosis patients is warranted to establish correlation between oxidative stress and mtDNA damage in PTB.

A Study on Chromosomal Analysis of Patients with Primary Amenorrhea.

BACKGROUND: Primary amenorrhea is one of the most common disorders seen as gynecological problems in adolescent girls. It refers to the participants who did not attain menarche by the age of 11-15 years. Chromosome abnormalities contribute as one of the etiological factors in patients with primary amenorrhea. AIMS: The aim of this study was to evaluate the frequency of chromosomal abnormalities and to investigate the abnormal karyotypes in patients referred with the symptom of primary amenorrhea for better management and counseling. SETTING AND DESIGN: One hundred and seventy-four cases of primary amenorrhea were referred from the obstetrics and gynecology department to our cytogenetic laboratory for chromosomal analysis. G-banded chromosomes were karyotyped, and chromosomal analysis of all patients was done. RESULTS: Out of 174 patients, we observed 23 (13.22%) participants with abnormal karyotype. In 23 cases of chromosomal abnormalities, 10 cases were sex reversal female (46,XY) and Turner karyotype (45,X) in 6 females. Other numerical and structural abnormalities were also seen such as 47,XXX; 45,X/47,XXX; 45,X/46, X,dic(X); 46,XX, inv (9); 45,X/46,X,i(Xq); 46,X,mar(X); and 45,X/46,XY in the primary amenorrhea cases. CONCLUSION: This study definitely attests the importance of chromosomal analysis in the etiologic diagnosis of primary amenorrhea patients. Karyotyping will help to counsel and manage the cases of primary amenorrhea in a better way. This study reveals the frequencies and different types of chromosomal abnormalities found in primary amenorrhea individuals and that might help to make the national database on primary amenorrhea in relation to chromosomal aberrations.

Molecular Genetic Study to Detect Prevalence of High-risk Human Papilloma Virus Strains (type 16 and 18) in Cervical Lesions and Asymptomatic Healthy Subjects of Rural Central India.

BACKGROUND: Carcinoma cervix of uterus (CaCx) is the most common malignancy affecting women worldwide. It is an established fact that infection of specific types of human papilloma virus (HPV) is essential for the development of cervical cancer. The present study reports the high-risk viruses (HPV 16 and 18) type distribution in rural central India, which has unique climatic condition. To our knowledge, no molecular study on HPV prevalence has been done in this region of rural population, this intended us do such study. MATERIALS AND METHODS: Sexually active women reporting to the Gynecology were divided in three groups, first being asymptomatic women with normal cervix (52 cases), second group with benign cervical lesion (52 cases), and third group of women with frank cervical malignancy (40 cases). Cervical swabs were collected for HPV DNA sampling. The incidence of HPV positivity was recorded in each group. RESULTS: Fifty-two women with asymptomatic normal cervix showed 44.23% positivity for HPV 16 and 5.76% positivity for HPV 18. Fifty-two women with benign cervical lesion showed 38.46% positivity for HPV 16 and 3.84% positivity for HPV 18. Forty women with frank cervical malignancy were with prevalence of 62.5% for HPV 16 and 22.5% for HPV 18. CONCLUSION: The results of the study are definitely helpful to know the prevalence of HPV in this region of rural population and will enrich the national epidemiological data related to HPV infection in cervical cancer.

Dermatoglyphics and karyotype analysis in primary amenorrhoea.

BACKGROUND: Dermatoglyphics is the scientific study of the skin ridge patterns on the fingers, toes, palms of the hands and soles of feet. Dermatoglyphics is in use as a supportive diagnostic tool in genetic or chromosomal disorders as well as in clinical conditions with genetic etiologies. Primary amenorrhoea and Dermatoglyphics, both have the suspected multifactorial (genetic and environmental) aetiologies. OBJECTIVE: In the present study the finger dermatoglyphic patterns were studied in primary amenorrhoea cases and age matched fertile control females and also attention was given to find out whether a specific dermatoglyphic trait exists in primary amenorrhoea cases and whether it was statistically significant. MATERIALS AND METHODS: To study the role of dermatoglyphics in primary amenorrhoea, a study was conducted on 30 subjects with primary amenorrhoea (as cases) and compared it with equal number of age matched fertile females (as controls). We studied fingertip patterns in all the subjects enrolled. Simultaneously we have assessed the Karyotype of primary amenorrhoea cases. RESULT AND CONCLUSION: Two subjects in experimental group have shown abnormal Karyotypes. The most significant finding in present study was increased total finger ridge count (TFRC) in primary amenorrhoea cases which was statistically significant. We also found higher frequency of loops and arches in primary amenorrhoea with abnormal karyotypes. This type of study may be quite useful as a supportive investigation, in stating the predisposition of an individual to primary amenorrhoea and referral of an individual for karyotyping.