Clinical measurement of intermalleolar distance in Western Indian population

Background: Angular deformities around the knee are one of the common basis of presentation at orthopaedic clinic and intermalleolar distance (IMD) is an essential anthropometric tool for evaluation of the angular status of the lower limb.Methods: 500 healthy (330 male and 170 female) subjects between 20 to 40 years of age were taken for IMD measurement in standing and supine position by digital vernier caliper.Results: The normal range of IMD in western Indian population in between 32-58 mm. IMD in standing position was 42.47 mm with (95% CI = 40.51 to 44.42 mm) and in supine position was 34.45 mm with (95% CI = 32.78 to 36.13 mm). Mean IMD in male in standing position was 40.01 mm while in female it was 43.74 mm observed. Statically significant difference was observed in posture change and according to age.Conclusions: Significantly higher value in female, in standing position and in higher age group were observed.

Relation of radial nerve to superficial bony and soft tissue landmarks- a cadaveric study

Background: Prevention of iatrogenic nerve injury during humerus fracture surgery would be of prodigious importance. Several methods were used to ease this type of injury but no flawless result is at hand. Therefore, this study was designed to predict the location of the radial nerve (RN) by bony as well as soft tissue landmarks and also identify the safe zone for RN in arm.Methods: Fifty upper limbs belonging to 25 cadavers with no macroscopic deformity of their elbow joint were dissected for the study. RN was dissected in the spiral groove of the humerus and measurements were taken from different anatomical landmarks.Results: There was no bilateral asymmetry as well as no statistical difference was observed in male and female measurements. The mean distance between olecranon to spiral groove 16.91±0.18 cm, olecranon to entry in Intermuscular septum 10.65±0.16 cm, triceps aponeurosis to RN in spiral groove 2.50±0.06 cm, medial epicondyle to upper margin of spiral groove 17.01±0.09 cm and lateral epicondyle to lower margin of spiral groove 10.97±0.12 cm was observed.Conclusions: Understanding the zone of danger of humerus provide more safety during surgical intervention of humerus by predicting the location of RN by different bony and soft tissue landmarks

The anatomical relationship of the superficial branches of radial nerve: a cadaveric study

Background: The major superficial branches of the radial nerve like inferior lateral cutaneous nerve of arm (ILCNA) and posterior cutaneous nerve of forearm (PCNF) are susceptible to get injured during surgical procedure done in distal half of humerus. Methods: In this study 25 voluntary donated cadavers were dissected to define the course and position ILCNA and PCNF of the radial nerve and their ramifications in relation to anatomical landmarks such as the lateral inter muscular septum or bony landmarks such as lateral epicondyle. Results: The inferior lateral cutaneous nerve of the arm arose from the radial nerve at the lower part of the spiral groove, at a mean of 14.8 cm proximal to the lateral epicondyle and 4.2 cm proximal to the uppermost fibres of the brachioradialis muscle. The posterior cutaneous nerve of the forearm arose from the inferior lateral cutaneous nerve at a mean of 6.7 cm proximal to the lateral epicondyle. Conclusions: The described lateral approach permits assessment of any part of the radial nerve and reduces the risk of iatrogenic injury

2017 Legislative Assembly election results: experts react

Yesterday the results were announced for five legislative elections held in Punjab, Uttar Pradesh, Uttarakhand, Manipur and Goa. Mukulika Banerjee, Surajit Bhalla, Meghnad Desai and Maitreesh Ghatak, who were at LSE for the fourth LSE SU India Forum, gathered to discuss key trends and features emerging from the results

An Innovative 3 Dimensional Model of Middle Ear

Background: Physical models are particularly useful in demonstrating complex topics in anatomy or those ones that are difficult to access when seen in the textbook or cadaver. One such topic is middle ear. Aim of the present study was to introduce a multicolored cardboard model of middle ear to provide ease in understanding of its anatomical structure.Methods: The participants were 2nd semester medical undergraduate class of students. They were exposed to a cuboidal multicolored model (made from cardboard box) with 6 walls that could be opened to see the details of structures related to them. Student feedback was taken through a structured Questionnaire based on Likert Scale (5 to 1).Results: More than 80% of students felt that this model was a good tool for visualizing complex anatomy of middle ear in small groups and it reduced the time needed for self- study. This model provided multifaceted feedback with active participation from students. A low fidelity middle ear model proved to be a practical low cost tool for use in both didactic and small group teaching.Conclusion: Low fidelity models continue to have a place in anatomy and can be integrated in the current curriculum.Keywords: Middle ear, 3 dimensional, teaching methodologies, gross anatomy education

Transverse cerebellar diameter: a reliable predictor of gestational age

Objectives: To determine accuracy of transverse cerebellar diameter (TCD) measurement in the prediction of gestational age (GA) in normal fetuses; to develop reference chart for TCD according to GA in Indian population. Design: A retrospective cross-sectional study. Method: Ultrasonographic measurements in 300 singleton pregnant women included biparietal diameter (cm), head circumference (cm), abdominal circumference (cm), femur length (cm) and transverse cerebellar diameter (cm). Reference chart with mean TCD for corresponding gestational age (GA) in weeks was developed. Results: Statistically significant relationship found between TCD and gestational age (R2=0.92, p=0.0006). Regression formulae based on TCD with other parameter can be used to predict gestational age of foetus. When TCD is compared with findings in other studies in different ethnic population, it is found that there is significant difference exists. Conclusion: In normally developing fetuses the TCD has linear correlation with advancing gestational age. A separate reference chart is required for every different population because ethnicity, nutrition and environmental factors can have impact on normal TCD values. This will help to avoid misinterpretation of data to determine gestational age

Dopamine induces functional extracellular traps in microglia

Dopamine (DA) plays many roles in the brain, especially in movement, motivation, and reinforcement of behavior; however, its role in regulating innate immunity is not clear. Here, we show that DA can induce DNA-based extracellular traps in primary, adult, human microglia and BV2 microglia cell line. These DNA-based extracellular traps are formed independent of reactive oxygen species, actin polymerization, and cell death. These traps are functional and capture fluorescein (FITC)-tagged Escherichia coli even when reactive oxygen species production or actin polymerization is inhibited. We show that microglial extracellular traps are present in Glioblastoma multiforme. This is crucial because Glioblastoma multiforme cells are known to secrete DA. Our findings demonstrate that DA plays a significant role in sterile neuro-inflammation by inducing microglia extracellular traps

Isthmus agenesis with variant topography of levator glandulae thyroideae: A case report

The thyroid gland is an imperative endocrine gland present in the neck known commonly for its morphological variations. During routine dissection agenesis of the isthmus of the thyroid gland was observed with levator glandulae thyroidea extending from both the lateral lobes with stout stalks of pyramidal lobes bilaterally. The Levator glandulae thyroidea is a fibro-musculo-glandular band. usually, present unilaterally or extending from isthmus connecting the pyramidal lobe of the thyroid gland to the hyoid bone. The site of the isthmus is often associated with anastomosis of vessels supplying thyroid gland but strikingly no such anastomosis was observed. The presence of such variant of levator glandulae thyroidea with agenesis of the isthmus is a rare finding and knowledge of such topographical anatomical variations is crucial for understanding associated pathologies related to the thyroid gland and modus operandi in their management

Highup Division of Median Nerve with Vascular Malformations: A case report

On the left side, after a cleaned dissection of axillary region for brachial plexus, two roots of median nerve have been found and in between two roots there is presence of axillary artery. Musculocutaneous nerve is emerging from lateral cord of brachial plexus. Branches of this nerve are supplying corachobrachialis muscle on the upper end after piercing it. Lateral root is dividing into two branches .Medial branch is uniting with the medial root to form the main trunk of median nerve and lateral branch is uniting with the main trunk in the lower third of arm and then the reunited nerve passes between two heads of pronator teres. There are arteriovenous malformations over cubital fossa like tangles and arteriovenous fistulas at the lower end of forearm between cephalic vein and radial artery. Bluish   discolouration was noted on fingernails of hand. Similar to the left side after a cleaned dissection of the axillary region for brachial plexus on right side, two roots of median nerve have been found. Lateral root is dividing into two branches, lateral & medial. Medial branch is joining the medial root of median nerve and lateral branch joins the main trunk in the middle of the arm to continue as main nerve trunk in the middle of the arm which then passes between two heads of pronator teres muscle, gives branches before piercing. There are no arteriovenous malformations or arteriovenous fistula on the right side which is present on the left side