Additional Muscle Slip of Bicipital Aponeurosis and its Anomalous Relationship with the Median Cubital Vein

The cubital region of the arm is a common site for recording blood pressure, taking blood for analysis and administering intravenous therapy and blood transfusions. During the routine dissection of a 70-year-old male cadaver at the Kasturba Medical College, Manipal, Karnataka, India, in 2015, it was observed that the aponeurotic insertion of the biceps brachii muscle divided into two slips. The medial slip fused normally with the deep fascia of the forearm, while flexor carpi radialis muscle fibres originated from the lateral slip. There was also a single vein in the forearm, the cephalic vein, which bifurcated to form the median cubital vein and the cephalic vein proper. The median cubital vein, further reinforced by the radial vein, passed deep to the two slips of the bicipital aponeurosis and then continued as the basilic vein. During venepuncture, medical practitioners should be aware of potential cubital fossa variations which could lead to nerve entrapment syndromes

A Cadaveric Report on a Giant Ureteric Stone Led Right Hydro Ureter and Severe Hydronephrosis

BACKGROUND: The ureter shows natural constrictions in its course, and these are the potential site for the impaction of the renal calculus. Giant ureteral stones are associated with insidious growth and late presentation, often leading to renal failure.CASE PRESENTATION: In the present case, we observed a huge ureteric stone obstructing the right ureterovesical junction in a 58 year-old male cadaver. We also found hydroureter distal to the impaction of the calculus, renal damage and severe hydronephrosis on the right side. Histopathological analysis showed conditions of arterio-nephro-sclerosis and eroded ureter secondary to the calculus. Ureteric stones obstruction may result in hydroureter, hydronephrosis and progressive renal damage leading to irreversible renal function. The present case provides valuable information regarding the gross and histopathological alterations in ureteric calculi.CONCLUSION: It further enables clinicians to be armed with the knowledge of preventive approaches to educate patients with previous calculi, or those who may develop in the future.

Histogenesis and Histomorphometric study of Human Fetal Small Intestine

Background: Intestine plays a major role for the normal growth of the fetus during the prenatal period. The process of the embryonic development is not quantified histologically. Therefore the main aim of the study was to measure the thickness of all part of the wall of the small intestine that are mucosa, submucosa and muscularis externa and to look for the appearance of the Brunner’s glands and Peyer’s patches in the submucosa of duodenum and ileum.Methods: The present study was carried out on 30 fetuses of gestational ages ranging from 11-36 weeks. Ten fetuses from each trimester were used in the study. Fetal small intestine were dissected carefully, and were separated as duodenum, jejunum & ileum and fixed in formalin solution. The tissue was processed for histology and then slides were stained with Haematoxylin and Eosin. The microscopic features were noted using light microscope.Results: The thickness of the mucosa, submucosa and the muscularis externa was observed to be increased in first trimester, decreased in the second trimester and again increased in the third trimester, which could be because of the increase cell turnover and the arrangement of the collagen fibers as to support the mucosa and the muscularis externa.Conclusion: Thus, the knowledge of the histogenesis and histomorphometry of the human fetal small intestine is crucial for the adult gastroenterologist to appreciate, because of the potential for these early life events to affect the responsiveness of the intestine to physiological or pathological challenges in later life.

HEPATOPROTECTIVE ACTIVITY OF AQUEOUS EXTRACT OF CAESALPENIA BONDUC AGAINST CCL4 INDUCED CHRONIC HEPATOTOXICITY

Objective: The leaves of Caesalpinia bonduc (CB) have been used against various disorders in folk medicine including the liver disorders. Earlier, we have shown the hepatoprotective effect of CB in acute hepatotoxicity model. The present study was designed to evaluate the anti-hepatotoxic and anti-fibrotic effect of the aqueous leaf extract of CB on CCl4 (carbon tetrachloride) induced chronic hepatotoxicity/fibrosis in Wistar rats.Methods: Animals were divided into three groups namely; preventive, curative and prophylactic, which was further subdivided into four groups each: Group I–untreated control, group II-CCl4 control, group III-CB+CCl4 and group IV–silymarin+CCl4. The aqueous extract of CB/silymarin was administered orally once, daily for eight weeks in the curative group and for four weeks in preventive and prophylactic groups respectively. The chronic liver damage/fibrosis was induced by intraperitoneal injection of CCl4 twice a week, for four weeks in preventive and prophylactic groups and for eight weeks in the curative group. Blood samples were collected for assaying serum biochemical parameters, and the livers were excised and processed for histology.Results: The data showed that supplementation of aqueous leaf extract of CB along with CCl4 significantly reduced the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase(ALP), total bilirubin(TB) and prothrombin time(PT) thus further restoring the total protein(TP) and albumin(ALB) in preventive, curative and prophylactic groups when compared to CCl4 control. Significant improvement in the microscopic structure of the liver further confirmed the hepatoprotective effect of aqueous extract of CB over the liver injury and fibrosis induced by CCl4 in rats.Conclusion: The study, therefore, suggests that aqueous extract of CB might provide a novel and alternative approach for treating the chronic hepatotoxicity/liver fibrosis.Keywords: Caesalpenia bonduc, Liver, Chronic, CCl4, Fibrosis, Silymarin, Hepato-protectio

BIOMECHANICAL, BIOCHEMICAL AND HISTOLOGICAL EVIDENCES FOR WOUND HEALING PROPERTIES OF INDIAN TRADITIONAL MEDICINES

Objective: Ayurveda, India's traditional medicinal system is a rich source of natural remedies, frequently used as home and folk medicine in wound healing due to easy availability and affordability. Honey, Ghee and roots of Glycyrrhiza glabra are effectively used in Ayurveda for treating wounds of various types. Nerium indicum (a folk medicine) is also a known healing agent. Even though the known end result of these medications is faster wound healing, the mechanism of actions at tissue level, changes in the micro-environment of the wound and quantification of the rate of healing is not explored and documented using modern scientific methods.Methods: Healthy Wistar rats were used for incision wound model. Wounds were inflicted and the treatment plan was followed with regular topical application of test materials. The nature of healing was observed regularly and photographed. At different interval of the treatment plan-biomechanical, biochemical and histological studies were carried out. An attempt was also made to quantify the microscopic changes at the wound site.Results: Faster healing was observed in all the animals treated with test materials. This was indicated by alterations in the nature of epithelisation, inflammatory changes, fibroblast recruitment and activity, fibrous composition and arrangement at the wound site in comparison with untreated group.Conclusion: The present study is useful in exploring the mechanism of action of these traditional Indian medicinal systems–Ayurveda and folk medicine and thereby provides scientific evidences for the same.Â

An Unusual Right Popliteal Vein Aneurysm in an Adult: A Case Report

The incidence of venous aneurysm is less than arterial aneurysms. Most of them are incidental findings with no major clinical significance. However, popliteal vein aneurysms may be potentially life threatening as they can be a source of pulmonary embolism and potentially even death. We report a case of right popliteal vein aneurysm in a 67-year-old male cadaver. Information from this case study may contribute to an improved understanding of these phenomena, including early detection of these or similar thromboembolic events.

An unorthodox innervation of the gluteus maximus muscle and other associated variations: A case report

Knowledge of peripheral nerve morphology, location, and variation is important for facilitating appropriate diagnosis and intervention. We present a unique case of absence of the inferior gluteal nerve and high division of the sciatic nerve. In this instance, the common peroneal nerve was found piercing the piriformis muscle and emerging distally in the form of two trunks: thin medial and thick lateral. The medial trunk presented an interesting course, supplying the gluteus maximus muscle before joining the lateral trunk to form the common peroneal nerve. Additionally, the arteria nervi ischiadisci was also observed accompanying and supplying the tibial nerve passing inferior to the piriformis. These variations are important for clinicians and surgeons for some radiological diagnoses and surgical procedures in the lower limb

PECTORO-EPICONDYLARIS: A RARE EXTENSION OF THE PECTORALIS MAJOR MUSCLE. Pectoro-epicondilaris: Una rara extensión del músculo pectoral mayor

El músculo pectoral mayor es propenso a varias incongruencias morfológicas. Diferentes deslizamien-tos musculares son comunes entre ellos. Sin embargo, durante la disección rutinaria de un cadáver masculino de 55 años por estudiantes de pregrado, se encontró una variante rara de la extensión tendinosa del músculo pectoral mayor. Surgía de la lámina profunda del tendón muscular bilaminar cerca de su inserción en el húmero. En su camino a unirse al tabique intermuscular medial del brazo y finalmente al epicóndilo medial del húmero, cruzó todas las estructuras en la parte delantera del brazo de lateral a medial. Considerando la extensión tendinosa de forma proximal, no se observó formación muscular separada. Esta variante de deslizamiento puede ser nombrada como músculo pectoral epicondilario. El conocimiento de esta variación particular puede ser de especial interés para los radiólogos y médicos en procedimien-tos tales como transformación de músculo, trasplante de tendón y uso en los colgajos miocutáneos durante cirugías reconstructivas. The pectoralis major muscle is prone to various morphological incongruities. Variant muscular slips are common among them. However during routine dissection for undergraduate students in a 55-year-old male cadaver, a rare variation of the tendinous extension of the pectoralis major muscle was found. It was arising from the deep lamina of the muscular bilaminar tendon close to its insertion to the humerus.  On its way to be attached to the medial intermuscular septum of the arm and finally to the medial epicondyle of the humerus, it crossed all the structures in the front of the arm from lateral to medial. Tracing this tendinous extension slip proximally, no separate muscular extension was observed. this variant slip may be named as pectoro-epicondylaris muscle. The know-ledge of this particular variation could be of special interest to radiologists and clinicians in procedures such as muscle transformation, tendon transplantation and use of myo-cutaneous flaps during reconstructive surgeries

Additional Muscle Slip of Bicipital Aponeurosis and its Anomalous Relationship with the Median Cubital Vein

The cubital region of the arm is a common site for recording blood pressure, taking blood for analysis and administering intravenous therapy and blood transfusions. During the routine dissection of a 70-year-old male cadaver at the Kasturba Medical College, Manipal, Karnataka, India, in 2015, it was observed that the aponeurotic insertion of the biceps brachii muscle divided into two slips. The medial slip fused normally with the deep fascia of the forearm, while flexor carpi radialis muscle fibres originated from the lateral slip. There was also a single vein in the forearm, the cephalic vein, which bifurcated to form the median cubital vein and the cephalic vein proper. The median cubital vein, further reinforced by the radial vein, passed deep to the two slips of the bicipital aponeurosis and then continued as the basilic vein. During venepuncture, medical practitioners should be aware of potential cubital fossa variations which could lead to nerve entrapment syndromes