Introduction: The placenta is a large organ that acts as an interface between the pregnant mother and the foetus, facilitating the maternal and foetal circulation. Morphology and morphometric analysis form the base for ultrasonography examination of the placenta. Aim: To study the morphology and the morphometry of the placenta. Materials and Methods: A cross-sectional study was conducted in the Department of Anatomy, Kanyakumari Government Medical College, Asaripallam, Kanyakumari, Tamil Nadu, India, between November 2024 and December 2025. A total of 50 freshly delivered placenta specimens fixed with formalin were collected. Gross examination included assessment of shape and measurement of diameter and thickness, along with evaluation of membrane attachment, umbilical cord insertion and vascular pattern, type of attachment of membranes, type of attachment of umbilical cord, pattern of blood vessels on the foetal surface and the intactness of both the foetal and maternal surfaces. Descriptive statistics were primarily employed. Categorical variables were expressed as frequencies and percentages. Continuous variables were summarised using mean, Standard Deviation (SD), and range (minimum-maximum values). Results: Of the placentae studied, 19 (38%) were discoid, 8 (16%) were oval, 8 (16%) were triangular, 14 (28%) were irregular, and 1 (2%) had a succenturiate lobe; placental diameter ranged from 10-26 cm and a mean diameter of 16.27±2.12 cm, while thickness ranged from 2-4 cm with a mean of 2.68±0.68 cm; 43 (86%) placentae showed marginal membrane attachment, 5 (10%) circummarginate, and 2 (4%) circumvallate; 23 (46%) placentae had paracentral cord insertion, 13 (26%) central, 8 (16%) eccentric, 5 (10%) marginal, and 1 (2%) velamentous, and 37 (74%) placentae exhibited a dispersed vascular pattern, 7 (14%) furcate, 4 (8%) magistral, and 2 (4%) mixed. Conclusion: The gross examination of the placenta reflects the intrauterine pathological conditions associated with stillbirth, intrauterine growth retardation, gestational diabetes mellitus, and hypertension.
Introduction: The histological maturation of the human foetal idney is a critical determinant of prenatal renal health and provides a primary baseline for diagnosing Congenital Anomalies of the Kidney and Urinary Tract (CAKUT). While contemporary molecular insights have expanded current understanding of renal development, detailed morphological benchmarks for the id-gestational period remain essential for clinical pathology and prenatal imaging. Aim: To delineate the sequential histogenesis milestones of the human kidney during the crucial 14- to 28-week gestational period. Materials and Methods: A cross-sectional observational histological study was conducted on 30 human foetuses (20 male, 10 female) ranging from 14 to 28 weeks of gestation at Department of Anatomy, MGM Medical College and Hospital, Chhatrapati Sambhajinagar. The study was conducted over a duration of two years, (January 2011- February 2013) to ensure the collection of adequate specimens for research. Gestational age was determined using Crown-Rump Length (CRL) and foot length. Renal specimens were fixed in 10% formalin for 24 hours, embedded in paraffin and serially sectioned at 7 μm thickness. Sections were stained with Haematoxylin and Eosin (H&E) and Masson’s Trichrome. Histological sections of foetal kidneys were examined under a light microscope at 4×, 10×, 40× and 100x magnifications. Qualitative evaluation included assessment of cortical maturation, corticomedullary differentiation, nephron development and sequential stages of glomerular maturation. Quantitative morphometric analysis was performed using a calibrated ocular micrometer to measure cortical thickness at standardised sites in each specimen. All observations and measurements were documented for individual specimens and subsequently grouped according to eight gestational age categories (14-28 weeks) to evaluate the chronological progression of renal histogenesis. Results: The Nephrogenic Zone (NZ) thinned progressively from 14 to 28 weeks. Concurrently, mean cortical thickness increased significantly from 754.68±53.40 µm to 2078.62±58.92 µm {Analysis of Variance (ANOVA), p<0.001}. This demonstrated a highly significant linear growth pattern (R2 =0.992), with the highest rate of growth occurring at 22-24 weeks (an increase of 284.63 µm). Glomerular maturation followed a centrifugal pattern, with primitive structures dominating superficially at 14-16 weeks. Proximal Convoluted Tubules (PCT) and Distal onvoluted Tubules (DCT) emerged at 18 weeks, becoming welldefined by 22 weeks. Corticomedullary differentiation began at 16-18 weeks; complete demarcation, well-organised pyramids and mature Ducts of Bellini were distinguishable by 28 weeks. Conclusion: The present study establishes a precise morphological timeline for mid-gestational renal histogenesis. The 22-28 week window represents a phase of intense maturation characterised by significant cortical growth and marked nephron polymorphism. These findings serve as a normative anatomical baseline essential for the prenatal diagnosis of congenital anomalies and understanding the impact of preterm birth on nephron endowment.
Primary ventral hernia and incisional hernia constitute a significant proportion of surgical practice. With a better understanding of anatomy and the availability of mesh and fixation devices, there is continuous evolution of techniques from Intraperitoneally placed composite mesh to extraperitoneal regular proline mesh placement over either a peritoneal flap or posterior rectus sheath flap, or more recently, a totally extraperitoneal approach without entering the peritoneal cavity. Laparoscopic techniques ensure reduced postoperative pain, reduced wound infections, and generally a gratifying outcome. In this case series of 129 patients who underwent laparoscopic repair of incisional and primary ventral hernias, females constituted the majority (97 patients), and prior gynaecological surgeries were the most common cause of hernia. Only 35 had primary ventral hernias. Intraperitoneal Onlay mesh with defect closure (IPOM PLUS) placement was the most commonly performed procedure due to its wide applicability, followed by Transabdominal Retromuscular (TARM) mesh repair. All procedures resulted in successful outcomes, with no instances of conversion to open surgery and no major postoperative complications. A single recurrence was noted at the one-year follow-up.
Introduction: Total Abdominal Hysterectomy (TAH) often results in significant postoperative pain due to the invasive nature of the surgery and the involvement of abdominal or pelvic structures. Amongst the myriad pharmacological options available, intravenous IV diclofenac, tramadol, and paracetamol stand out for postoperative pain management due to their distinct mechanisms of action and efficacy profiles. Aim: To compare the effectiveness of IV diclofenac, IV tramadol, and IV taracetamol in postoperative TAH patients. Materials and Methods: This prospective interventional study was conducted in the Department of Obstetrics and Gynaecology at Jaipur National University Institute of Medical Sciences and Research Centre (JNUIMSRC), Jaipur, Rajasthan, India between September 2023 and November 2024. A total of 150 patients aged 35-55 years who were undergoing elective hysterectomy in the Inpatient Department (IPD) were recruited. Information was collected using a pretested, structured proforma for each patient. The patients were randomly assigned to three groups for postoperative pain management, with 50 patients in each group. Group A was administered IV diclofenac 75 mg eight hourly. Group B was administered IV paracetamol at 1 g 8-hourly. Group C was administered IV tramadol 50 mg n 100 mL NS 8-hourly. Visual Analogue Scale (VAS) was used to assess pain intensity at 6, 12, and 24 hours after surgery. Continuous variables were expressed as mean±standard deviation. Categorical data were expressed as percentages and proportions. Results: The mean age of patients administered diclofenac was 43.60±4.73 years, with paracetamol was 44.10±4.33 years and with tramadol was 44.22±4.18 years, difference being statistically insignificant. The difference between the three groups was statistically significant (p-value=0.01), with the VAS score being lowest in the paracetamol group than in the other two groups postoperatively. The VAS scores in the IV paracetamol group were 6.26, 4.18, and 1.82 at 6, 12, and 24 hours postoperative, respectively. The VAS score in the IV diclofenac group was 7.14, 5.14, and 3.26 at 6, 12, and 24 hours postoperatively. Whereas the VAS scores in the IV tramadol group were 7.06, 4.22, and 2.14 at 6, 12, and 24 hours postoperatively. The most common side-effects observed were nausea, vomiting, and epigastric pain. Nine patients in the tramadol group had sideeffects compared to seven patients in the diclofenac group and three patients in the paracetamol group. Additional medications were required for 10 patients in the diclofenac group, nine in the tramadol group, and six in the paracetamol group. Conclusion: The findings of the study indicate that IV paracetamol provided superior pain relief compared with diclofenac and tramadol and was associated with fewer adverse effects.
Introduction: Postpartum Haemorrhage (PPH) remains a leading cause of maternal morbidity and mortality worldwide. Oxytocin is the first-line uterotonic agent used during caesarean delivery to prevent uterine atony. However, the optimal mode of administration-intravenous bolus versus infusion- remains controversial due to differences in haemodynamic responses and adverse effect profiles. Aim: To compare the haemodynamic effects and uterotonic efficacy of intravenous oxytocin administered as a bolus versus infusion in women indergoing elective caesarean delivery under spinal anaesthesia. Materials and Methods: This prospective observational study was conducted in the Department of Anaesthesia at S.S. Institute of Medical Sciences and Research Centre, Davangere, Karnataka, India, between September 2015 and August 2017. A total of 60 parturients aged 20-35 years with American Society of anaesthesiologists (ASA) physical status I or II scheduled for elective caesarean delivery were included. Based on the discretion of the attending anaesthesiologist, patients received oxytocin either as an intravenous infusion (Group 1, n=30) or as an intravenous bolus (Group 2, n=30). Haemodynamic parameters were recorded at one, three, and five minutes following oxytocin administration. Uterine tone, requirement for additional uterotonic agents, and adverse effects were also documented. Results: The mean age was comparable between Group 1 and Group 2 (26.8±3.2 vs 25.9±3.6 years; p-value=0.28), with the majority of patients classified as ASA I (80%). At one minute post-administration, Group 2 demonstrated a significantly greater reduction in mean arterial pressure (MAP) compared to Group 1 (77.0±6.4 vs 83.7±5.9 mmHg; p-value=0.020). Uterine tone at three and five minutes was comparable between the groups (p-value >0.05). Additional uterotonics were required in nine patients (30%) in Group 2 compared to six patients (20%) in Group 1. Adverse effects such as nausea and vomiting were more frequent in Group 2 (5 patients, 16.7%) than in Group 1 (2 patients, 6.7%). Conclusion: Intravenous oxytocin infusion provides uterotonic efficacy comparable to bolus administration with better early haemodynamic stability and fewer immediate adverse effects.
Introduction: Conventional Coronary Angiography (CAG) is the established procedure for the detection and quantification of coronary artery stenosis and myocardial perfusion defects. The left main coronary artery typically bifurcates into the Left Anterior Descending (LAD) and circumflex arteries. However, significant anatomical variations exist, particularly in the course and extent of the LAD artery as it supplies the cardiac apex. Understanding these morphometric variations, alongside cardiac dominance, is critical for accurate diagnostic and interventional procedures. Aim: To investigate the morphometric characteristics of the LAD and its relationship with cardiac dominance in a patient population with normal angiograms. Materials and Methods: The present cross-sectional study, conducted by the Anatomy and Cardiology Departments from November 2023 to May 2025 at the tertiary health Institution Dr RPGMC Tanda, Kangra, Himachal Pradesh, India, examined characteristics of the LAD artery in 381 patients aged 20-80 years with a normal coronary angiogram. Data on the LAD type, length, and diameter were collected. Data were analysed using descriptive statistics and inferential tests, including student’s t-test and chi-square test, with a significance threshold of p<0.05. Results: Type III was most frequent (n=365), followed by Type II (n=12) and Type I (n=4). The mean length of the LAD artery was 100.2±10.49 mm, while the mean LAD lumen diameter was 2.17±0.23 mm. There was no statistically significant difference among the three types of LAD (p=0.595). Right cardiac dominance was more prevalent (n=321), with 60 patients having left dominance. Conclusion: Type III LAD and right cardiac dominance are the most prevalent anatomical patterns in the studied population. These findings are essential for optimising risk stratification and planning precision revascularisation procedures.
Introduction: Laparoscopic Cholecystectomy (LC) is the gold standard for the management of gallbladder disease; however, the loss of tactile feedback increases the risk of Bile Duct Injury (BDI). Rouviere’s Sulcus (RS) serves as an important extrabiliary anatomical landmark that helps define a safe plane of dissection during surgery. Aim: To determine the prevalence, morphological variants, and morphometric dimensions of RS and to evaluate its association with demographic characteristics in patients undergoing elective LC. Materials and Methods: This hospital-based cross-sectional study was conducted from January 2024 to June 2025 in the Department of General Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. Hundred adult patients undergoing elective LC were included. Intraoperative visualisation and morphometric assessment of RS, including its length, width, and depth, were performed using a standardised four-port laparoscopic technique. The sulcus was classified into four morphological types (Types I-IV) based on established criteria. Due to small subgroup sizes for certain RS variants, Fisher’s exact test was used instead of Pearson’s Chi-square test when expected cell counts were fewer than 5. A p-value <0.05 was considered statistically significant. Results: The study population had a mean age of 48.24±13.73 years and comprised 78 females and 22 males (female-to-male ratio: 3.5:1). RS was identified in 80% of patients (95% CI: 71.2%- 86.7%). Type I (Open type) was the predominant morphological variant, observed in 91.25% of visualised sulci, followed by Type III (5.0%), Type IV (2.5%), and Type II (1.25%). The mean length, width, and depth of Type I sulci were 21.00±10.02 mm, 2.56±1.95 mm, and 2.38±1.78 mm, respectively. No significant association was observed between RS morphology and patient age (p-value=0.626) or gender (p-value=0.848). Conclusion: The RS is a highly consistent and reliable anatomical landmark during LC, with its morphology remaining independent of demographic factors.
Introduction: Ileostomy is frequently performed to divert faecal flow and protect distal bowel anastomoses in both elective and emergency surgical settings. However, postoperative complications remain a significant cause of morbidity and may affect patient recovery. Aim: To evaluate the frequency and temporal pattern of complications following ileostomy during the first 12 weeks after surgery. Materials and Methods: This prospective observational study was conducted in the Department of General Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India from July 2024 to December 2025. A total of 50 adult patients undergoing elective or emergency ileostomy were enrolled. Demographic, clinical, and laboratory parameters were recorded. Patients were assessed during hospitalisation and followed-up at four, eight, and 12 weeks for the occurrence of stoma-related complications. Results: The study included 50 patients with a mean age of 45.44±18.31 years; 66% were females. Emergency procedures accounted for 80% (n=40) of surgeries, and a loop ileostomy was performed in 94% (n=47) of cases. The common indications were malignancy (n=24, 48%), bowel obstruction (n=14, 28%), and perforation (n=12, 24%). During hospitalisation, 45 (90%) patients remained free of complications. This proportion decreased to 36% (n=18) at four weeks, then improved to 68% (n=34) at eight weeks and 88% (n=44) at 12 weeks. Skin excoriation was the most common complication at four weeks (n=19, 38%), followed by stomal prolapse (n=5, 10%) and high-output stoma (n=4, 8%). Retraction, parastomal hernia, stenosis, and necrosis were infrequent late complications. Conclusion: Ileostomy-related complications follow a distinct temporal pattern, with the highest frequency occurring during the first month after surgery.
Acute Necrotising Encephalopathy (ANE), also known as Acute Necrotising Encephalopathy of Childhood (ANEC), is a rare and fulminant encephalopathy, usually triggered by viral infections, characterised by rapid neurological decline and distinctive neuroimaging features, particularly bilateral thalamic involvement. The authors, here present three cases of ANE, one with a rapid catastrophic presentation with shock, seizures and encephalopathy, where the 10-month-old male child had uncal herniation within four hours of admission, the second one involved eight-year-old boy who had acute encephalopathy and seizures, and the third one who was an adolescent female aged 17 years, had a less severe presentation of mild irritability and aphasia. The present case series underscores the pivotal role of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) in early diagnosis of ANE. The case series also highlights the importance of early, aggressive immunomodulation to achieve favourable outcomes in ANEC.
Introduction: The Sylvian Fissure (SF), which divides the temporal lobe from the frontal and parietal lobes, is a crucial anatomical landmark in neurosurgery. Magnetic Resonance Imaging (MRI) based data on SF morphological variations in the Indian population remain limited, despite its clinical significance. Aim: To evaluate and classify anatomical variations of the SF in healthy adults using MRI. Materials and Methods: The present retrospective observational study was conducted in the Department of Radiodiagnosis at Sri Manakula Vinayagar Medical College and Hospital, Puducherry, India, from January 2025 to June 2025. A total of 325 adults aged between 30 and 60 years were included. Individuals with structural or functional abnormalities of the brain were excluded. Five types (I-V) of SF morphology were identified using T1- weighted axial, coronal, and sagittal images, and hemispheric symmetry was evaluated. Results: Among the 325 MRI brain scans analysed, Type I and Type II SF morphologies were the most frequently observed in both hemispheres. On the right-side, Type II was the most common pattern {140 (43.1%)}, followed closely by Type I {139 (42.8%)}. On the left-side, Type I predominated {144 (44.3%)}, followed by Type II {138 (42.5%)}. Overall, symmetrical SF morphology was observed in the majority of participants {291 (89.5%)}, while asymmetry was noted in a smaller proportion {34 (10.5%)}. Conclusion: By establishing normative reference data, these findings strengthen the utility of MRI in preoperative assessment and underscore the relevance of standardised SF classification in neurosurgical and radiological practice.
Introduction: Anatomy remains a cornerstone of medical education, yet its vast volume often leads to poor long-term retention. As the current curriculum moves toward studentcentric models, understanding how Gen Z (Generation Z roughly born between 1997-2012) learners perceive various interactive teaching methods beyond traditional didactic lectures is essential for curricular optimisation. Aim: To compare the perceived efficacy of Interactive Lectures (IL), Self-Directed Learning (SDL), and Peer Discussion (PD) in fostering understanding of concepts and retention of gross Anatomy among medical undergraduates. Materials and Methods: The present cross-sectional survey was conducted at PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India, from January to May 2025. Data from 309 students were collected via a 5-point Likert scale instrument. The data were analysed using KruskalWallis H tests for inter-method comparison followed by DunnBonferroni post-hoc test analysis (Statistical Package for Social Sciences (SPSS) v.20). Results: Data were collected from 309 students (Phase I: n=196; Phase II: n=113) comprising 151 males (48.9%) and 158 females (51.1%), with a mean age of 18.9±0.9 years. PD emerged as the superior method for both long-term retention (4.72±0.45) and exam-day recollection (4.68±0.47). In contrast, SDL was rated significantly lower, particularly regarding topic retention (2.72±1.08; p<0.001). Conclusion: Peer-led environments and IL outperformed unstructured SDL. The marked dissatisfaction with SDL suggests that, without formal training or structured faculty-led facilitation, independent learning may be counterproductive in a high-volume subject like anatomy.
The Craniovertebral Junction (CVJ) comprises of the skull base (occipital bone), upper cervical spine (atlas and axis) and surrounding neurovascular structures, including the brainstem, spinal cord and vertebral arteries. Its stability depends on strong ligaments, membranes and bony anatomy, allowing key movements like rotation and flexion-extension. Cervical myelopathy significantly affects quality of life and can be caused by both common and rare causes. Common causes include degenerative disc disease, cervical spondylosis, spinal stenosis, herniated discs and trauma, all of which lead to compression of the spinal cord due to wear, injury, or misalignment in the cervical spine. Less common causes involve congenital abnormalities in the spinal structure, tumours, infections, rheumatoid arthritis, atlanto-occipital membrane issues and Chiari malformation, all of which lead to spinal cord compression. Despite a thorough diagnostic evaluation, around 20% of cases remain idiopathic. The authors hereby, present a case of a 59-year-old male with suboccipital and neck pain radiating predominantly to the left upper and lower limbs, accompanied by paraesthesias. Imaging revealed a congenital anomaly of the atlas, characterised by the absence of the left half of the posterior arch (Currarino type B). This structural defect led to stretching and ventral displacement of the Posterior Atlanto-occipital Membrane (PAOM), resulting in compression and myelomalacia of left hemispinal cord.
Introduction: Each kidney is typically drained by a single renal vein, though variations exist. Sometimes, more than one renal vein may drain the kidneys, which is clinically significant as they often play a significant role in surgeries related to the kidneys. Aim: To measure the morphological parameters of renal veins, as well as additional renal veins if present. Materials and Methods: A cross-sectional study was conducted in the Department of Anatomy, Assam Medical College and Hospital, Dibrugarh, Assam, India from October 2021 to October 2024. A total number of 52 formalin-fixed human cadavers of both sexes were dissected, which included both adults (n=17) and perinatal cadavers (n=35). The parameters were the length and diameter of the renal veins and, if present, those of accessory renal veins. The length of the renal veins was measured with a measuring scale. The diameter of the renal veins was measured by using Vernier’s calliper. Continuous variables were reported as Mean±Standard Deviation. The categorical findings were expressed in percentages. Results: Of the 52 cadavers studied, 37 (71.2%) were males, 15 (28.8%) were females. The study included 104 renal veins. The length of the adult Right Renal Vein (RRV) and Left Renal Vein (LRV) was 2.46±0.41 cm and 7.06±0.51 cm. In the case of a perinatal cadaver, the length of the right and LRVs was 1.21±0.3 cm and 1.86±0.5 cm, respectively. Of the 52, 3 (5.8%), showed the presence of accessory renal veins. Accessory renal vein on the left-side was present in 2 (3.8%) cadavers, whereas 1 (1.9%) cadaver showed it on the right-side. Conclusion: The variations and course of renal veins help in nephrectomy and renal transplantation surgeries.
Introduction: Vertical integration in medical education bridges basic and clinical sciences, enhancing the relevance and retention of knowledge. Graduate Medical Education Regulations 2019 (GMER 2019) permits up to 20% of content to be delivered through integration, promoting meaningful, application-based learning. Need for the Study: Cervical cancer requires an understanding of Anatomy, Pathology, Microbiology, and Clinical Management, making it ideal for demonstrating how vertical integration improves the application of basic and clinical knowledge. There are only a few research articles on vertical integration in Indian medical colleges. Aim: To assess the impact of vertical integration in medical education in a medical college in the northeastern state of Manipur. Materials and Methods: A quasi-experimental study involving 92 second-year MBBS students will be conducted at Churachandpur Medical College, Imphal campus, Imphal, Manipur, India, from November 2024 to September 2025. The intervention consists of a two-hour vertically integrated teaching module on cervical cancer, combining didactic lectures with a Demonstrate-Observe-Assist-Perform (DOAP) session. Students will undergo pre and post-intervention assessments using validated Multiple Choice Questions (MCQs) and Objective Structured Clinical Examination (OSCE) stations. A paired Student’s t-test will be used to compare mean scores, with a p-value <0.05 considered statistically significant.
Introduction: The practical teaching of neuroanatomy is challenging because of the fragility of brain tissues, scarcity of specimens, and the need for visualisation of minute structural details. This requires an upgrade in teaching methodology to enhance learning and overcome problems in neuroanatomy practical teaching. Incorporating prerecorded videos of neuroanatomy specimens into practical teaching could help bridge this gap. Aim: To evaluate the prerecorded neuroanatomy specimen videos as a supplementary tool in teaching the practical aspect of neuroanatomy. Materials and Methods: This crossover educational interventional study was conducted at SMIMER Medical College, Surat, Gujarat, India from October 2024 to September 2025. All 250 first year MBBS students who volunteered were assigned to two groups using computer-generated sampling. The study was conducted in two phases with two different neuroanatomy topics. In phase I, after the theory lecture on Topic 1, Group A was exposed to prerecorded videos of neuroanatomy specimens, and Group B was taught directly using conventional cadaveric specimens in the dissection hall by the same faculty. In phase 2, after the theory lecture on Topic 2, both groups were flipped, and the same procedure was repeated. At the end of each phase, students were provided with Multiple Choice Questions (MCQs) (to assess topic-related knowledge) and a Likert scale-based questionnaire (to assess their perception of the teaching method they were exposed to). After completing both phases, a dichotomous response questionnaire was administered to gather final feedback on the preferences and effectiveness of the two teaching modalities. The collected data were analysed using both between-group and crossover comparisons, including unpaired and paired statistical tests for MCQ score, the Chi-square test for the Likert Questionnaire, and the Z-test for dichotomous responses. Results: In this study, of the 250 students, 108 were male, and 142 were female, with a mean participant age of 17.18±0.63 years. The mean MCQ Score for Topics 1 and 2 was 5.11±1.44 and 4.90±1.62 in the prerecorded video teaching method, and 4.11±1.46 and 3.65±1.80 in the dissection hall teaching method, respectively, and were found statistically significant. Analysis of Likert-scale questionnaire data showed statistically significant results for the prerecorded video teaching method in terms of overall satisfaction, better visualisation of specimen details, audibility of information, achievement of learning objectives, and enhancement of neuroanatomy knowledge (p-value <0.001). Conclusion: The present study analysed students’ perceptions of practical teaching methodologies in neuroanatomy and found that prerecorded videos of neuroanatomy specimens can serve as a supplementary tool alongside conventional dissection hall teaching.
Introduction: Knowledge of variations in the vascular anatomy of the circle of Willis is necessary for radiologists and neurosurgeons performing radiological procedures and intracranial surgeries. Aim: To identify vessels forming the Circle of Willis and to determine the incidence of its variations in the Circle of Willis in cadaveric brain specimens. Materials and Methods: A retrospective observational study was conducted in the Department of Anatomy, PSG Institute of Medical Sciences and Research, Coimbatore Tamil Nadu, India, from February 2021 to January 2024. A total of 30 brain specimens, including those of both genders, were removed and fixed in formalin. The variations that were observed are hypoplasia, aplasia, duplication, and differences in the dimensions between opposite segments. Observations regarding shape, symmetry and architecture were noted. The variations in the vessels that form the Circle of Willis were identified. Comparison of length and diameter between right and left-sided arteries of the Circle of Willis was done with Student’s paired t-test. Results: Out of the total of 30 available human brain specimens, 22 specimens presented with the classic shape (heptagonal) of the Circle of Willis. Eight specimens showed variation in the Anterior Cerebral Artery (ACA). One specimen showed variation in the Posterior Cerebral Artery (PCA). Ten specimens showed variation in the Anterior Communicating Artery (ACoA) and 12 specimens showed variations in the Posterior Communicating Artery (PCoA). Conclusion: Knowledge of variations in the Circle of Willis is essential for radiologists and neurosurgeons to interpret angiography and plan neurovascular procedures accurately.
Introduction: Gender discrimination from body parts is a difficult task in forensic investigations. In such instances, handprints can serve as valuable evidence. Gender-specific regression equations, suggesting correlation between stature and anthropometric hand measurements, can be a successful tool to know the unknown. Aim: To assess the relationship between handprint dimensions and stature and to develop regression models for stature estimation based on Handprint Length (HPL) and Handprint Breadth (HPB). Materials and Methods: This cross-sectional study was conducted in the Department of Anatomy at Late Shri Lakhiram Agrawal Memorial Government Medical College, Raigarh, Chhattisgarh, India, from March 2024 to July 2024. A total of 82 participants (32 males and 50 females), aged 17 to 22 years, were enrolled, including both right- and left-handed individuals. Hand impressions of both hands were obtained by pressing clean, dry hands onto evenly spread moulding clay on a flat surface, ensuring uniformity and minimising distortion. From each impression, HPL and HPB were measured using standardised anthropometric procedures. Standing stature was recorded for each participant using calibrated instruments. Descriptive statistics were computed for all variables. Simple linear regression analysis and Pearson’s correlation coefficients (r) were used to evaluate associations, while the Student’s t-test was applied to assess statistical significance. A p-value of less than 0.05 was considered indicative of significance. Results: Handprint measurements demonstrated a significant positive correlation with stature in both male and female participants, whose mean age was 19.5 years. The HPL of the right hand ranged from 15.4 cm to 22.8 cm, with a mean of 18.56±1.23 cm, while the left hand ranged from 15.7 cm to 22.7 cm, with a mean of 18.42±1.15 cm. Stature among the sampled population varied from 142 cm to 178.5 cm, with males exhibiting a mean stature of 169.68±4.97 cm and females 155.74±5.30 cm. Pearson’s correlation coefficients (‘r’) indicated a moderate positive association between HPL and stature in males (right hand: r=0.468; left hand: r=0.556) and females (right hand: r=0.477; left hand: r=0.528). In contrast, HPB showed a comparatively weaker correlation with stature across both genders. Conclusion: The consistency of regression models affirms HPL as a dependable predictor of stature and highlights the need for population-specific calibration.
Introduction: Acute appendicitis is one of the most prevalent surgical emergencies worldwide, with complications arising from delayed diagnosis or misdiagnosis. Accurate and timely diagnosis is critical to prevent complications like perforation, abscess, and peritonitis, while minimising unnecessary surgeries. Aim: To study the diagnostic accuracy of Tzanakis Scoring (TS) versus the Alvarado scoring system, considering histopathology as a gold standard. Materials and Methods: A prospective observational study was conducted at the Outpatient Department (OPD) of Surgery and Emergency Room (ER), S Nijalingappa Medical College (SNMC), HSK (Hanagal Shree Kumareshwar) Hospital and Research Centre, Bagalkot, Karnataka, India from August 2022 to February 2024. A total of 100 patients who presented with right lower quadrant pain were included. Both the Modified Alvarado Score (MAS) and TSs were calculated for each patient. The diagnostic performance of each scoring system was evaluated against histopathological findings. The sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), and diagnostic accuracy were calculated for both the MAS and TS. Receiver Operating Characteristic (ROC) curves were constructed to determine the optimal cut-off values for each scoring system. Results: The mean age was 29.3±11.8years, and out of 100 patients, 54 were males. A total of 75 had histologically confirmed appendicitis. The TS demonstrated higher sensitivity (92.0% vs 88.0%), specificity (80.0% vs 76.0%), and diagnostic accuracy (89.0% vs 85.0%) compared to MAS. The Area Under the ROC Curve (AUC) was 0.895 for the TS and 0.860 for MAS (p-value<0.001 for both). Cut-off values were ≥8 for the TS and ≥7 for MAS. Both scoring systems reduced negative appendectomy rates compared to clinical judgment alone (4.1% for TS, 5.6% for MAS, vs 8.5% for clinical judgment). Conclusion: Both the MAS and TS are effective tools for diagnosing acute appendicitis, with the TS showing slightly superior performance. These scoring systems can aid in clinical decision-making and potentially reduce negative appendectomy rates. Further large-scale studies are warranted to validate these findings across diverse populations.
Vestibular Schwannoma (VS) is a benign tumour of the vestibulocochlear nerve and accounts for nearly 85% of Cerebello-Pontine (CP) angle tumours. Its occurrence during pregnancy is infrequent, with only a few cases reported worldwide. Managing VS in pregnant patients presents unique challenges, as both maternal neurological status and foetal safety must be considered when deciding the timing and approach to surgery. We report the case of a 23-year-old primigravida at 12 weeks of gestation who presented with progressive headache, blurred vision, imbalance, and left-sided hearing loss. Neurological examination revealed bilateral papilloedema, left facial nerve involvement, sensorineural hearing loss, with Magnetic Resonance Imaging (MRI) brain showing a left CP angle tumour with hydrocephalus. The patient initially underwent an emergency right ventriculoperitoneal shunt for symptomatic relief, followed by a retromastoid suboccipital craniotomy for tumour excision under Intraoperative Neurophysiological Monitoring (IONM). The tumour was safely debulked using a Cavitron Ultrasonic Surgical Aspirator (CUSA), which allowed selective tumour removal with the preservation of critical neurovascular structures. The patient recovered without new neurological deficits, continued her pregnancy to term, and delivered a healthy baby via caesarean section. Histopathological examination confirmed VS, and postoperative MRI at six months showed gross total resection with no recurrence.
Introduction: Ophthalmic artery is the first branch of the internal carotid artery and provides an indirect approach to flow pattern and velocimetry information to less approachable intracranial circulation. Aim: To obtain the normative reference value of maternal Ophthalmic Artery Doppler (OAD) velocimetry in the second trimester. Materials and Methods: The present cross-sectional study was conducted on 700 patients who visited the hospital for antenatal ultrasound in the second trimester at the Department of Radiodiagnosis and Imaging, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. Maternal OAD was performed with a GE Voluson E8 Expert BT12 (Wipro GE) using a linear 5-10 MHZ transducer. After recording the patient history, various doppler indices like First Peak Systolic Velocity (PSV1), Second PSV2, Pulsatility Index (PI), End Diastolic Velocity (EDV), Resistivity Index (RI), Systolic to Diastolic ratio (S/D) and PSV2 to PSV1 ratio (PSV ratio: PSV2/PSV1) were recorded. Descriptive analyses were performed using Statistical Package for Social Sciences (SPSS) version 25.0 to compute frequencies, percentages, means, and standard deviations. Results: A total of 700 subjects were included with a mean age of 28.28±5.63 and a mean Body Mass Index (BMI) of 25.89±2.71 kg/mm². The mean systolic blood pressure and diastolic blood pressure was 117.87±8.38 and 78.42±5.70, with Mean Arterial Pressure (MAP) 91.49±5.75. The OAD velocimetry revealed the mean PSV1 value of 33.05±6.71 cm/sec, PSV2 value of 16.22±3.66 cm/sec. Similarly, mean PSV2/PSV1 and EDV values were 0.49±0.07 and 5.76±1.54 cm/sec, respectively. The other doppler parameters like mean PI, RI and S/D values were 2.43±034, 0.82±0.04, and 6.07±1.85. Conclusion: Establishing reference values for maternal OA doppler parameters is crucial for distinguishing between normal and pathological pregnancies. Change from normal values may indicate a pathological state like increased vascular resistance, which usually results at around 20th week of gestation. These changes may be the earliest indication of future development of preeclampsia, which requires earlier detection for proper management.
