Ibn Sina Medical College

Chiari malformation type I (CM-I) often leads to syringomyelia (SM) through impaired cerebrospinal fluid (CSF) flow at the craniocervical junction, resulting in progressive neurological deficits. A 27-year-old woman presented with a 6-month history of severe occipital headaches, neck pain, bilateral upper limb numbness, quadriparesis (MRC 3/5), and ataxia. MRI revealed 23-mm cerebellar tonsillar herniation and an extensive syrinx from C2 to T3 (maximal diameter 11 mm). She underwent suboccipital craniectomy, C1 laminectomy, bilateral subpial tonsillectomy, and expansile duraplasty with autologous fascia lata graft. Intraoperative Valsalva confirmed restored CSF flow. Postoperatively, headaches and neck pain resolved immediately. At 1 month, strength improved to MRC 4/5 with reduced numbness; by 3 months, full neurological recovery (MRC 5/5, no ataxia or sensory deficits) was achieved. Follow-up MRI showed near-complete syrinx resolution (< 3 mm residual cavity) and normalized CSF dynamics, without complications like cerebellar ptosis. This case demonstrates the efficacy of a comprehensive surgical approach incorporating bilateral tonsillectomy in severe CM-I with extensive SM, yielding rapid radiological and clinical improvement within 3 months.

ABSTRACT Suicide notes provide unique insight into the psychological state, emotions, and interpersonal experiences preceding death. However, little is known about it in Bangladeshi culture. This study aimed to analyze the thematic, psychological, and linguistic characteristics of suicide notes in Bangladesh and explore sex‐based differences. A retrospective content analysis was conducted using publicly available Bangladeshi newspaper reports. Suicide notes were identified through searches using English and Bangla keywords across multiple search engines. Psychological and emotional themes were coded using a structured framework informed by previous suicide note research and established suicide theories. Descriptive and comparative analyses between males and females were performed using Chi‐square and Fisher's exact tests. After duplicate removal, 58 unique cases were included. Most suicide notes were handwritten (87.9%), written in Bangla (96.6%), and private in nature (86.2%). Emotional pain (86.2%), hopelessness (81%), desire to escape (75.9%) and acceptance of death (56.9%) were the predominant psychological themes. Hopelessness was significantly higher among males ( p < 0.05), whereas anger was significantly more common among females ( p < 0.05). Negative emotional language predominated across notes. Suicide notes in Bangladesh reflect intense psychological suffering shaped by interpersonal conflict and sociocultural pressures.

Abstract not available International Journal of Human and Health Sciences Vol. 10 No. 03 Jul’26 Page: 131-133

Context: The linear measurements of trochlea differ from person to person depending on race, age, sex and stature. These are helpful in management of reconstructive surgery, trochlear fracture, prosthetic elbow replacement, postoperative evaluation and also an important factor for assessment of various upper limb dimorphism. The present study is intended to estimate the linear measurements of trochlea among the adult Bangladeshi people and to find out the variations between males and females. Materials and Methods: A cross-sectional analytical study was carried out in the Department of Anatomy, Sir Salimullah Medical College, Dhaka from July 2018 to June 2019. Digital radiograph of elbow joint A/P view and lateral view were taken from 80 medical students (male 40 and female 40) aged between 21 years to 25 years. Then different linear measurements of trochlea were measured by using the “MB Ruler” software. Results: The study showed that values of measurement of Trochlear Breadth (TB), Trochlear Constriction Length (TCL), Trochlear Sulcus Depth (TSD) were significantly higher in male than female; nonsignificant higher value was found in male regarding trochleo-capitular sulcus depth. Conclusion: Findings of the present study revealed that most of the linear measurements of trochlea were higher in male. Bangladesh Journal of Anatomy January 2023, Vol. 21, No. 1, pp. 25-29

Background: The patella is a key determinant of patellofemoral congruence, tracking, and contact stress. Small variations in its shape can influence patellofemoral pain, instability, and postoperative anterior knee symptoms. Among patellar morphologic indices, the apex angle reflects inferior pole geometry, while the lateral facet ratio quantifies lateral facet dominance; both parameters may affect trochlear engagement and patellar tilt. This study aimed to assess sex-related differences in apex angle, lateral facet ratio, and major patellar morphometric parameters in dry adult human left patellae, highlighting their potential surgical and morphological implications. Materials & Methods: This cross-sectional analytical study was conducted at the Department of Anatomy, Dhaka Medical College, from January 2018 to June 2019. A total of 150 dry adult human left patellae of unknown sex were examined. Sex was assigned using linear discriminant function analysis based on maximum patellar height and width, classifying 92 specimens as male and 58 as female. Morphometric measurements were recorded using a digital slide caliper, a flexible wire for curved surfaces, and a protractor for apex angle. Weight and volume were measured using an electronic balance and a graduated glass cylinder, respectively. Results: Among the 150 dry left patellae, 92 (61.33%) were classified as male and 58 (38.67%) as female. Male patellae were significantly larger in major dimensions and mass, including height (42.10 ± 1.99 vs 36.16 ± 2.31 mm), width (42.87 ± 1.80 vs 36.94 ± 1.58 mm), thickness (20.73 ± 1.25 vs 18.69 ± 1.39 mm), weight (10.59 ± 2.13 vs 6.79 ± 1.45 g), and volume (10.88 ± 1.98 vs 7.10 ± 1.34 cm³), all p < 0.01. Males also exhibited greater ridge height and facet widths (all p < 0.01), with small but significant differences in facet thickness (p = 0.001-0.002). In contrast, females showed a significantly higher apex angle (110.17 ± 10.80° vs 104.65 ± 6.80°, p < 0.01) and a higher lateral facet ratio (0.61 ± 0.04 vs 0.58 ± 0.03, p < 0.01), corresponding to mean differences of 5.52° (95% CI: 2.37-8.67; g = 0.64) and 0.03 (95% CI: 0.018-0.042; g = 0.87), respectively. Patellar index and median ridge position did not differ significantly between the sexes (p = 0.599 and p = 0.127). Correlation analysis showed a weak, non-significant association between apex angle and lateral facet ratio (r = 0.11, p = 0.167), whereas lateral facet ratio correlated moderately and negatively with facet widths (r = -0.36, p < 0.01). Conclusion: Male patellae were significantly larger in overall size and facet dimensions. Conversely, female patellae exhibited a higher apex angle and lateral facet ratio. No sex-based differences were observed in patellar index or ridge position. Bangladesh Journal of Anatomy July 2023, Vol. 21, No. 2, pp. 50-56