Virgin coconut oil - its methods of extraction, properties and clinical usage: a review.

Abstract: Virgin coconut oil (VCO) is a processed edible oil, which is removed from the mature coconuts. It is a colourless water insoluble liquid and obtained by the hot and cold extraction processes. The nutritional components of VCO are mainly contributed to by lauric acid, its primary content. VCO has shown its anticancer, antimicrobial, analgesic, antipyretic and antiinflammatory properties. Because of these medicinal properties, VCO has gained the wider attention among the medical field. Most evidently VCO has shown its potential antioxidant property, because of its phenolic compounds and medium chain fatty acids. It is one of the beneficial compounds used to prevent and treat the oxidative stress induced neurological disorders like stress, depression and Alzheimer's disease. Dietary supplementation of VCO is easy and economical and safer in daily life among all age groups. It is also beneficial for the cardiovascular, respiratory, dermatological, reproductive and bone health. It can also be applied to the skin as a moisturizer in the paediatric age group. Hence, exploration of antioxidant property as well as other beneficial effects of VCO in various health conditions will be valuable.

A 20-44 GHz Wideband LNA Design Using the SiGe Technology for 5G Millimeter-Wave Applications.

This paper presents the design and implementation of a low-noise amplifier (LNA) for millimeter-wave (mm-Wave) 5G wireless applications. The LNA was based on a common-emitter configuration with cascode amplifier topology using an IHP's 0.13 µm Silicon Germanium (SiGe) heterojunction bipolar transistor (HBT) whose f_T/f_MAX/gate-delay is 360/450 GHz/2.0 ps, utilizing transmission lines for simultaneous noise and input matching. A noise figure of 3.02-3.4 dB was obtained for the entire wide bandwidth from 20 to 44 GHz. The designed LNA exhibited a gain (S_21) greater than 20 dB across the 20-44 GHz frequency range and dissipated 9.6 mW power from a 1.2 V supply. The input reflection coefficient (S_11) and output reflection coefficient (S_22) were below -10 dB, and reverse isolation (S_12) was below -55 dB for the 20-44 GHz frequency band. The input 1 dB (P1dB) compression point of -18 dBm at 34.5 GHz was obtained. The proposed LNA occupies only a 0.715 mm2 area, with input and output RF (Radio Frequency) bond pads. To the authors' knowledge, this work evidences the lowest noise figure, lowest power consumption with reasonable highest gain, and highest bandwidth attained so far at this frequency band in any silicon-based technology.

Novel ensemble of optimized CNN and dynamic selection techniques for accurate Covid-19 screening using chest CT images.

The world is significantly affected by infectious coronavirus disease (covid-19). Timely prognosis and treatment are important to control the spread of this infection. Unreliable screening systems and limited number of clinical facilities are the major hurdles in controlling the spread of covid-19. Nowadays, many automated detection systems based on deep learning techniques using computed tomography (CT) images have been proposed to detect covid-19. However, these systems have the following drawbacks: (i) limited data problem poses a major hindrance to train the deep neural network model to provide accurate diagnosis, (ii) random choice of hyperparameters of Convolutional Neural Network (CNN) significantly affects the classification performance, since the hyperparameters have to be application dependent and, (iii) the generalization ability using CNN classification is usually not validated. To address the aforementioned issues, we propose two models: (i) based on a transfer learning approach, and (ii) using novel strategy to optimize the CNN hyperparameters using Whale optimization-based BAT algorithm + AdaBoost classifier built using dynamic ensemble selection techniques. According to our second method depending on the characteristics of test sample, the classifier is chosen, thereby reducing the risk of overfitting and simultaneously produced promising results. Our proposed methodologies are developed using 746 CT images. Our method obtained a sensitivity, specificity, accuracy, F-1 score, and precision of 0.98, 0.97, 0.98, 0.98, and 0.98, respectively with five-fold cross-validation strategy. Our developed prototype is ready to be tested with huge chest CT images database before its real-world application.

A Preliminary Study of Real-time Capturing and Sharing of Routine Health Data among the Public Health Professionals.

CONTEXT: Electronic health record (EHR) has the potential to make available the real-time data of the patient to the healthcare professionals by connecting all levels of the public health system, irrespective of their geographical boundaries. AIM: This study aims to test the capturing and sharing of real-time patient data at primary, secondary, and the tertiary level. SETTINGS AND DESIGN: The cloud-based EHR system developed earlier was used to capture real-time data of the patient visiting a primay health center (PHC) in Udupi District of Karnataka. SUBJECTS AND METHODS: About 100 patient records including laboratory and pharmacy data have been captured into the EHR system. The confidentiality of patient data is assured. RESULTS: The result of the study indicated no errors while capturing and sharing the patient data in real time. The system also evidenced the availability of vital statistics about the patient visiting PHCs. The system also allowed the professionals at referral level to view patient data for providing quality healthcare. CONCLUSION: EHR plays a vital role in capturing, storing, and sharing patient data for providing quality healthcare and it should be made mandatory by the central health agencies in the provision of patient care and reporting of notifiable communicable diseases at all levels.

Synostosis of dorsolumbar spine: an anatomical investigation with emphasis on clinical and embryological details.

PURPOSE: The objectives were to study the morphology of fused vertebrae in thoracolumbar region. MATERIALS AND METHODS: The study included 729 thoracolumbar vertebrae which were macroscopically observed for the fusion and morphological details were observed. RESULTS: It was observed that, there was fusion in three of our specimens. One specimen was having fusion between the two typical thoracic vertebrae. The other one had fusion among the three typical thoracic vertebrae. The third specimen had fusion between the twelveth thoracic vertebrae and the first lumbar vertebra. The average length of body of thoracic vertebrae was 1.8 mms, vertebral foramen diameter was 1.4 mms, length of lamina was 1.9 mms and the length of spinous process was 2.6 mms. The same parameters for the fused vertebrae of two typical thoracic was 3.2 mms, 1.1 mms, 4 mms and 4.7 mms respectively. The parameters of fused three typical thoracic vertebrae were 5.2 mms, 1.4 mms, 6.6 mms and 7.9 mms respectively. The average morphometric parameters of the fused thoracolumbar vertebrae were 3.7 mms, 1.4 mms, 4 mms and 3.5 mms respectively. CONCLUSIONS: The present study has provided additional information on the anatomy and morphology of dorsolumbar spine synostosis with their embryological basis and clinical implications. We believe that the details are clinically important as they might be associated with neurological signs and symptoms.

Morphological study of lingula of the mandibles in South Indian population.

PURPOSE OF THE STUDY: The objectives were to study the morphology of the lingulae in adult human dried mandibles of South Indian population. MATERIALS AND METHODS: The study was carried out on 67 (37 males and 30 females) dry mandibles and the morphological variants of the shapes of the lingulae were macroscopically noted and classified. Totally, 134 lingula were studied from both sides of mandibles. RESULTS: From our observations, 29.9% (40) of the lingula had triangular shape, 27.6% (37) were truncated, 29.9% (40) were found nodular and 12.6% (17) were assimilated. In 61.2% (41) of the mandibles, the shape of the lingula was symmetrical on both the sides. The triangular lingulae were found bilaterally in 14, truncated in 11, nodular in 10 and assimilated in six mandibles. CONCLUSION: In our specimens, the majority of the mandibles were having triangular shaped lingula and the shape of the lingula was symmetrical on both sides. There was sexual dimorphism observed, as in males the triangular shape was more common and in females it was nodular. The incidence of different forms of lingulæ can be used as an anthropological marker to assess the different group of population and races, with other non-metric variants of the skull. The morphology of this subject is important to the maxillofacial and orodental surgeons as the inferior alveolar nerve is close to the lingula and may assist in the inferior alveolar block.

Cervical spine synostosis: an anatomical study with emphasis on embryological and clinical aspects.

PURPOSE: The objectives were to study the anatomical features of fused vertebra in the cervical region. MATERIALS AND METHODS: The study included 363 cervical vertebras which were macroscopically observed for the fusion and their morphology was studied. RESULTS: Among our specimens, one fusion was observed between the C1 and C2 and the other was between C2 and C3. The mean anteroposterior diameter of normal atlas and axis were 42.1 +/- 0.9 mm and 46 +/- 0.5 mm respectively. The fused C1-C2 had 39 +/- 0.6 mm anteroposterior diameter. The mean lengths of anterior arch of normal atlas and body of axis were 16 +/- 0.9 mm and 23 +/- 0.7 mm respectively and the fused C1-C2 body length was 30 +/- 0.3 mm. The mean anteroposterior diameter of normal C2 and C3 vertebra were 46 +/- 0.5 mm and 47 +/- 0.8 mm respectively and of fused C2-C3 was 44 +/- 0.2 mm. The body length of C2 was 23 +/- 0.7 mm and C3 was 33 +/- 0.1 mm. The body length of fused C2-C3 was 36 +/- 0.8 mm. CONCLUSION: The present study has provided additional information on the anatomy, morphology of cervical spine synostosis with their embryological basis and clinical implications.

Aortic aneurysm: a case report with emphasize on microscopic and surgical anatomy.

We report a case of fusiform type of abdominal aortic aneurysm which was found during the routine dissection of a cadaver, done for teaching the undergraduate medical students. The aneurysm was seen unruptured and positioned below the renal arteries, just above the aortic bifurcation. This study illustrates the microscopic and surgical anatomy of the aneurysm with added literature review and clinical implications. We believe that the knowledge of this vascular pathology will be enlightening for broad specialties of medicine and medical science researchers alike.

Morphometry of A1 segment of the anterior cerebral artery and its clinical importance.

BACKGROUND AND AIM: Anterior cerebral artery, one of the terminal branches of the internal carotid artery is an important vessel taking part in the formation of circle of Willis. It supplies a large part of the medial surface of the cerebral hemisphere containing the areas of motor and somatosensory cortices of the lower limb. Aim of this study was the morphometry of A1 segment of the anterior cerebral artery. MATERIALS AND METHODS: 93 formalin fixed brain specimen of either sex and of Indian origin were studied. The mean length, mean external diameter and the anomalies present in A1 segment of the vessel were studied in detail and photographed. RESULTS: The mean length of A1 segment of the vessel was 14.49+/-0.28 mm and 14.22+/-0.22 mm on right and left side respectively. The mean external diameter of the vessel on right and left side was 2.12+/-0.07 mm and 2.32+/-0.06 mm respectively. Narrowing, aneurysm formation, buttonhole formation and median anterior cerebral artery were the anomalies seen with an occurrence of 15.05%, 5.37%, 3.22% and 12.9%, respectively. The above anomalies did not have any sex or side predilection. CONCLUSION: Knowledge of morphometry of the vessel will be of use to neurosurgeons while performing the shunt operation, in assessing the feasibility of such operations and in the choice of patients. From this study we infer that the morphometry of anterior cerebral artery varies in different population and that the neurosurgeons operating should have a thorough knowledge of the possible variations.

An anomalous left external jugular vein draining into right subclavian vein: a case report

Knowledge of the varying drainage patterns of superficial veins of head & neck, in particular, jugular veins are not only important for anatomists but also for the surgeons operating at this level and to clinicians in general. The variations are important for interventional radiologists too who perform transjugular procedures, such as port implantations and the transjugular intrahepatic portosystemic shunt or selective venous samplings. Results of recent studies report that the superficial veins, especially the external jugular vein (EJV), is been increasingly utilized for cannulation to conduct diagnostic and therapeutic procedures. We report a very unusual presentation of external jugular vein on left side of an embalmed male cadáver. Embryological evaluations of the anomaly was done and compared with available literature which showed that the observed variation is rare.

El conocimiento de los diferentes patrones de drenaje de las venas superficiales de la cabeza y cuello, en particular, las venas yugulares no sólo son importantes para anatomistas, sino también para los cirujanos que operan a este nivel y para los médicos en general. Las variaciones son importantes también para los radiólogos intervencionistas, quienes realizan procedimientos transyugulares, así como implantaciones portales y portosistémicas transyugulares intrahepáticas o derivación venosa selectiva. Resultados de estudios recientes informan que la venas superficiales, especialmente la vena yugular externa, es cada vez más utilizada para la canulación en diagnósticos y procedimientos terapéuticos. Se reporta una muy inusual variación anatómica de la vena yugular externa del lado izquierdo, presente en un cadáver embalsamado de sexo masculino. Fueron realizadas evaluaciones embriológicas de la anomalía y se compararon con la literatura mostrando que se trata de una variación rara.

Anatomical variations of the thyroid gland: possible surgical implications.

INTRODUCTION: The organogenesis of the thyroid gland in humans is often disturbed, leading to a variety of morphological variations of the gland, such as hypoplasia, ectopy, hemiagenesis and agenesis. As the morphological variations are usually diagnosed incidentally during examination for other thyroid gland diseases, the true incidence is therefore uncertain. METHODS: This study was structured to investigate the gross anatomical features of the thyroid gland in 105 (88 male and 17 female) cadavers from the coastal belt of southern India, an endemic goitre region. RESULTS: The pyramidal lobe was present in 61 (58 percent) male cadavers, and 52 (49.5 percent) cadavers showed the presence of the levator glandulae thyroideae. 33 percent of the specimens studied showed agenesis of the isthmus. However, the accessory thyroid tissue was found in only one cadaver. CONCLUSION: This study highlights the various developmental anomalies of the thyroid gland, which forms a cornerstone to safe and effective surgery.

Effect of Phyllanthus niruri Linn. treatment on liver, kidney and testes in CCl4 induced hepatotoxic rats.

Phyllanthus niruri extract is extensively used in treating liver ailments. Effects of aqueous extract of P. niruri on liver, kidney and testes of CCl4 induced hepatotoxic rats were studied. High levels of malondialdehyde (MDA) were observed in the CCl4 test group with significant reduction of MDA levels in all groups on P. niruri extract administration. Highest levels of glutathione (GSH) were found in P. niruri group. Activities of alanine transaminase, aspartate transaminase and alkaline phosphatase enzymes were significantly reduced in the curative group (P. niruri treatment after CCl4 injection). Histopathology of liver showed lesser degree of inflammation in all P. niruri treated groups while the renal and seminiferous tubules showed eosinophilic protein casts with signs of tubular damage and degeneration. Testes also showed decreased amount of mature spermatozoa. The results suggest that P. niruri has anti-oxidant and hepato-protective activity with associated deleterious effects on kidney and testes.

A cadaveric study of the testicular artery in the South Indian population.

INTRODUCTION: The male gonadal arteries, namely the testicular arteries, may vary at their origin and arise from the renal artery, suprarenal artery or lumbar artery. They may also be doubled, tripled or even quadrupled and may arise as a common trunk. With the advent of new intra-abdominal operative and laparoscopic techniques, the anatomy of the gonadal vessels has assumed much more importance. Therefore, a study was designed to assess the percentage of normal and aberrant origin and course of the testicular artery in the Indian population. METHODS: The posterior abdominal walls of 34 male cadavers (68 sides) were dissected and studied for the variations in the origin and course of the testicular arteries. RESULTS: In 85.3 percent of the cases, the male gonadal artery was normal in origin, number and course. However, in the remaining 14.7 percent, various anomalies in the testicular artery were noted. CONCLUSION: The variations in the testicular arteries are attributed to their embryological origin. A deep knowledge of these variations and their relations to the adjacent structures is very important in avoiding the complications in operative surgery.

Accessory brachialis muscle: a case report.

Variations of arm flexors are not uncommon with the exception of brachialis muscle. The role of brachialis is critical as it is the primary flexor of the elbow joint. Variations of brachialis are rare in literature. We present a case of an accessory-brachialis muscle (AcBr), found during routine cadaveric dissection. The AcBr originated from the lateral aspect of the brachialis muscle and lateral intermuscular septum. During its course towards the elbow, it crossed over the radial nerve and the distal tendon splits into two. The medial slip ran over the ulnar artery and merged with the deep fascia covering the pronator teres muscle, whereas lateral slip was inserted to the fascia covering the supinator. In the ipsilateral arm, an additional lateral cutaneous nerve of forearm (LCNF) was found coursing over the brachialis muscle medial to the LCNF. Clinical consideration of the present variations has been discussed. The present variation should be considered in the etiology of radial-tunnel syndrome (RTS).

Teratogenic effects of the anticonvulsant gabapentin in mice.

INTRODUCTION: We aim to study and elucidate the safety profile of the antiepileptic doses of gabapentin during pregnancy, and to evaluate gabapentin-induced murine fetotoxicity at different dose levels. METHODS: A total of 60 pregnant mice, divided into 12 groups of five mice each, were exposed to gabapentin in four different doses of 0 (control), 113, 226, or 452 mg/kg body weight per day, at three different gestational stages including early gestation (1-6 days), mid-gestation (7-12 days), and late gestation (13-17 days). The pregnant mice were euthanized on day 18 of gestation, and foetuses were examined for teratogenic manifestations. Their brains were dissected and examined for gross changes, malformations, histological changes, and quantitative protein estimation. RESULTS: Foetal resorptions were observed in all treated groups with gabapentin administration at early gestation (1-6 days), and mid-gestation (7-12 days). On the other hand, growth retardation along with stunting in size of live foetuses were observed in all the mid-gestation (7-12 days), and late gestation (13-17 days) treated groups. Various gross malformations were observed with all the three doses (113, 226, and 452 mg/kg body weight per day) when gabapentin was administered at mid-gestation (7-12 days). The same trends were confirmed by gross and microscopic examination of brains along with quantitative protein estimation. CONCLUSION: Gabapentin should not be prescribed during pregnancy, as no therapeutic dose of gabapentin is safe during this period as far as the foetal well-being is concerned.

The branching pattern and communications of the musculocutaneous nerve.

Anatomical variations of peripheral nerves are important and can help explain otherwise incomprehensible clinical findings. A study of 26 right and 18 left formalin-preserved upper limbs identified the fact that the musculocutaneous nerve is subject to considerable anatomical variation, including communication with the median nerve. A study of its branching pattern made us aware of why debility after trauma to the lateral aspect of the upper arm may be more than expected, and this study considers the clinical and surgical importance of these variations of the musculocutaneous nerve.

Third head of biceps brachii in an Indian population.

INTRODUCTION: The biceps brachii is one of the muscles of the anterior compartment of the upper arm. It is characteristically described as a two-headed muscle that originates proximally by a long head and a short head. The present study was carried out to find the occurrence of a third head of biceps brachii among a sample Indian population from the southern coastal part. METHODS: The arms of 42 cadavers were dissected and observed for variations in the origin and insertion of biceps brachii muscle bilaterally. The cadavers were embalmed and preserved in ten percent formalin. RESULTS: Among 42 arms studied, three had biceps brachii with three heads on the right side. The third head was of humeral origin, which inserted into the radial tuberosity by a common tendon with the long and short heads. The results of the present study compared with that of previous studies from medical literature shows that the occurrence of a third head of the biceps brachii muscle is relatively rare in Indians. CONCLUSION: Knowledge of the existence of the third head of biceps brachii may become significant in preoperative diagnosis and during surgery of the upper limb.

Clinically-relevant variations of the carotid arterial system.

INTRODUCTION: Developmental anomalies in the origin and branching pattern of the external carotid artery are not common. The level of the bifurcation of the common carotid artery and also the variations in the origin/branching pattern of the external carotid artery are well known and documented. METHODS: The variations in the level of bifurcation of the common carotid artery and the branching pattern of the external carotid artery were studied on 95 cadavers (52 male and 43 female). The common, external and internal carotid arteries were dissected on both sides. The level of carotid bifurcation was determined by comparison with the cervical vertebrae. Branching patterns of the carotid arteries were examined. RESULTS: Apart from the textbook description of the arteries, we came across several interesting variations. The bifurcation level of the common carotid artery was determined to be 50 percent at the C3 level, 40 percent at the C4 level and ten percent at the C2 level on the right side, and 55 percent at the C3 level, 35 percent at the C4 level, one percent at the C5 level and nine percent at the C2 level on the left side. CONCLUSION: Anatomical knowledge of the origin, course, and branching pattern of the external carotid artery, as well as the level of bifurcation of the common carotid artery, will be useful to surgeons when ligating the vessels in the head and neck regions during surgery and to avoid unnecessary complications during carotid endarterectomy.

Vertebral body integrity: a review of various anatomical factors involved in the lumbar region.

UNLABELLED: The body of the vertebra can be affected in the majority of the conditions involving the lumbar spine. Multiple references, both books and periodicals, have been reviewed, and the anatomical factors responsible for the vertebral body integrity in the lumbar spine have been included under the following important areas, namely, morphology, development, genetics, microscopic examination using histology, structural architecture, blood supply, neuromuscular control, and biomechanics. INTRODUCTION: The anatomy provides a three-dimensional frame work to support the interaction between the physiological and pathological alterations. The body of the vertebra can be affected in a majority of acute or chronic conditions involving the lumbar spine. The etiology of these conditions is multifactorial, which has been dealt with in previous studies sporadically. This study aims to review and incorporate the important anatomical factors which can influence the integrity of vertebral bodies in the lumbar region and manifest as low back pain. METHODS: Multiple references, both books and periodicals, have been reviewed for the literature. Electronic databases, including Medline and PubMed, were used to collect the latest information. They were finally arranged in an anatomical framework for the article. An attempt has been made to cover these relevant issues in an integrated way in the article and have been structured into introduction, morphology, development, genetics, microscopic examination using histology, structural architecture, blood supply, neuromuscular control, biomechanics, and conclusion. The aforementioned anatomical aspects, some of which have received less attention in the literature, may be helpful to clinicians for restoring the mobility, stability, and load bearing capacity of the lumbar spine as well as planning better management strategies, especially for the chronic low back pain. RESULTS: In our article all the anatomical factors affecting the integrity of vertebral body, including the morphology, development, genetics, growth and ossification, blood supply, specifically in the lumbar region, have been described, which were not covered earlier. The limitations of this review is its wide dimensions; hence, there are fair scopes of missing many relevant facts, as all of them cannot be compiled in a single article. We have attempted to confine our views to different anatomical domains only, this is our second limitation. Additional studies are required to incorporate and discuss the uncovered relevant scientific details. CONCLUSIONS: The integrity of the body of the lumbar vertebra is multifactorial (Fig. 8). The vast spectrum of the anatomical domain influencing it has been summarized. The evolution of erect posture is a landmark in the morphology of human beings and the lumbar lordosis, which has also contributed to the gross design of the vertebral body, is one of the most important adaptations for axial loading and bipedal movements. The role of metamerism in the evolution of vertebrate morphology is repeated in the development of spine. The body of the vertebra is intersegmental in origin, which results in dual vascular and nerve supply, both from superior and inferior aspects of the body of the lumbar vertebrae. The vertebral body ossifies from three primary centers, one for centrum, which will form the major portion of body, and the other two for neural arches. The cartilaginous growth plate is mainly responsible for the longitudinal vertebral growth. Regional differentiation of the vertebral column, and the definite pattern of the structure of the different vertebra, is regulated by a large number of genetic factors, including the Hox genes. The vertebral body design therefore provides the requirements for optimal load transfer by maximal strength with minimal weight. Bone mineral density (BMD), bone quality, microarchitecture, and material properties are the important factors that contribute to bone strength. BMD is highly heritable; bone mineral distribution and architecture are also shown to be under strong genetic influence. All the aforementioned factors finally integrate to ensure mainly the mobility, stability, and load bearing capacity of the lumbar spine.