Background: The gall bladder development in fetal life is complex and starts as early as the 4th week of gestation; the abnormal development of the gall bladder is associated with various congenital abnormalities. The objective of the present study was to study fetal gall bladder development in relation to gestational age (GA) among fetuses. Methodology: In a cross-sectional observational study of 29 fetuses, the gall bladder parameters and histological changes are evaluated at different gestational age. The fetus was categorized based on GA into three categories of <20 weeks, 21–30 weeks, and 31 weeks and above. After dissection of the abdomen, the shape and location of the gall bladder were observed. The relationship of gall bladder with liver was observed. The gall bladder length (GBL) and gall bladder width (GBW) were measured. The histogenesis of the gall bladder was observed among all fetuses and developmental changes were noted. Results: The study included 29 fetuses, 14 males and 15 females. The first, second, and third groups comprised 5, 14, and 10 fetuses. The GA ranged from 13 to 35 weeks. The mean crown-rump length (CRL) of the fetuses was 19.34 ± 6.32 cm. The mean GBL was 2.06 ± 0.83 cm and the mean GBW was 0.77 ± 0.32 cm. The GBL and GBW increased with CRL, GA, and weight. The strong positive correlation was observed between GBL, GBW with GA and CRL. On microscopy, among the first group, fetal gall bladder at 13 weeks showed solid structure with obliterated lumen and area of early canalization. The muscular layer initially was very thin and comprised only few haphazardly arranged muscle fiber in the first group, the thickness was found to be more in the second group and a well-formed adult-like muscular layer was found in the third group. The loose connective tiisue, the outer most layer was pronounced in the third group. Conclusion: The fetal gall bladder parameters show linear increase with GA and CRL. The location, size, and relation of the fundus with margin of gall bladder in fetus undergo changes with the development of the fetus. The fetal gall bladder undergoes marked histological changes during development.

Objective: Foetal ureter is developed by ureteric bud shows many developmental changes. Normal histology of the fetal ureter at various stages of development was studied to get insight into the morphology of fetal ureter. It is necessity for correlation with increase in gestational age and pathological changes for normal functioning of urinary system in fetal life. Method: Dissection of 87 normal human fetuses was done and histological findings of ureter were noted with respect to the age. The histology was studied by using H & E and Masson’s trichome stain. Important developmental stages were studied. Result: chronological fetal ureteral histology is different from adult Unlike in adult ureter, oval shaped lumen shows multiple epithelial layers with circularly arranged, At 12 weeks, the smooth muscle layer was in a single layer with an abundance of interspersed collagen fibers. Vascularization increases with age in lamina propria and division of muscular layer as inner longitudinal and outer circular layer occurs. Development of transitional epithelium increased in layers by 34 weeks in the lumen. Later on, the lumen changes to star shaped by multiple mucosal folds. At 36 weeks, the thickness of the wall increased significantly with a decrease in collagen. There was no trace of longitudinal muscle fibers even upto 33 weeks. Conclusion: Epithelial, muscular and connective tissue components displayed significant changes during intra uterine development The present study will be helpful in understanding the normal histological architecture of Foetal ureter and add to the existing knowledge regarding its development, its relation with gestational age and pathogenesis. Key words: Transitional epithelium, lamina propria, ureteric bud, Masson’s trichome.

Background: The purpose of the study was desired to investigate and observe the variations in the morphology of spleen in human fetuses.The spleen is the largest secondary lymphoid organ, in the fetal stage it also performs the role of haematopoiesis.It acts as a blood filter, and also acts as storage site for iron, erythrocytes, and platelets.Materials and Methods: This study has been carried out on spleen of 40 formalin preserved human fetuses (19 males and 21 females) of different gestational ages, in the Department of Anatomy, Government Medical College, Haldwani over a period of two years (i.e.2014-2016), with due regards on ethical grounds.Various gross parameters of spleen such as its location, shape, relations, notches & fissures and ligaments were observed and the results were statistically analyzed.Results: Spleens in all the fetuses was located in the left hypochondrium.60% of the fetal spleens were wedge shaped.While stomach was related to the spleen in all the gestational ages, kidney and left colic flexure were not related to the spleen in the early age of the fetus.Liver and left adrenal gland also showed relations with the fetal spleen.Maximum number of notches was present in the superior border followed by inferior border and lateral pole.Fissures were also seen in 11 spleens.Conclusion: Knowledge about prenatal ontogenesis of the spleen will help to understand the mechanisms of pathology in the organ and create methods of diagnosis and prevention.

•The present study was done to observe various changes related to the development of spleen in intrauterine life.•Measurements of splenic dimensions were done at different gestational ages of formalin preserved dead fetuses.•There is a consistent and statistically significant increase in the splenic dimensions.•The present study presents the tabulated data and is followed by discussion in the light of existing literature.

Background and Aims: Spleen is the largest secondary lymphatic organ. It acts as a graveyard for RBCs, is essential for immune responses, performs lymphopoiesis in adults and haemopoiesis in fetuses. The present study was conducted to assess the histogenesis of spleen in human fetuses in view of existing literature. Material and Methods: The study was carried out on 34 formalin preserved human fetuses procured from Dr Sushila Tiwari Government Hospital, Haldwani with due clearance from ethical committee. The 6 |jm sections of the spleen were stained with Haematoxylin and Eosin and observed under light microscope. Results: At 14 tol5 weeks, spleen had extensive sinusoids filled with RBCs and few lymphocytes. At 16-18 weeks, trabecular arteries were noticed more towards centre along with extensive haemopoietic cells in the venous sinusoids. By 20th week lymphocytic aggregation had started around arterioles. By 24 weeks periarteriolar lymphatic sheath was clearly observed. At term (37-40 weeks), classical primary lymphoid follicle was present but germinal centers were not observed. Conclusion: During earlier differentiation, spleen symbolizes the function of haemopoietic activities and gradually during subsequent gestation; it establishes its identity as a principle lymphoid tissue.

Introduction: Limited information is available on developmental morphology of human fetal caecum.Embryologically, the caecal swelling appears as a small conical dilation of the caudal limb of primitive intestinal loop and it is the last part of the gut to return in the abdominal cavity.During rotation of gut it is located in the right upper quadrant below the right lobe of the liver.From here it descends into the right iliac fossa.The present study aims to locate the position and shape of caecum at different gestational ages of fetuses.Material and methods: Thirty eight human fetuses (n=38) of 11-40 wks gestational ages were procured from Dr. Sushila Tiwari Memorial Hospital, Haldwani.Fetuses were dissected, illeocaecal region was displayed.The position and shape of caecum were recorded in situ.Out of 38 fetuses caecum was conical in 19 fetuses.Quadrangular in 10 fetuses and in 9 fetuses caecum is right saccular.Position of caecum was right subhepatic in18 fetuses, right lumber in 15 fetuses and right iliac fossa in 5 foetuses. Results:The location of caecum in relation to abdominal regions presented higher incidence of subhepatic position in less than 30 weeks fetuses and right iliac fossa position in more than 30 weeks fetuses.With increasing gestational age position of caecum changes from right subhepatic position to right iliac fossa.Fetuses belonging to less gestational ages, caecum was conical in shape, however as the gestational age is increasing, caecum was noticed as quadrangular and right saccular in shape. Conclusion:The observations are in favor of developmental process on the localization of caecum.

Background and aims: The cortical glomerulus shows many developmental changes during fetogenesis. Normal histology of the fetal glomerulus at various stages of development was studied to get insight into the morphology of fetal glomerulus. Fetal glomerular study is a necessity for correlation with increase in gestational age and pathological changes which may affect the normal functioning of kidneys in fetal life. Method: Dissection of 70 normal human fetuses was carried out and histological findings of glomerulus were noted with respect to the age of fetus. The histology of fetal kidney was studied using H & E stain. Important developmental stages of glomerulus were observed. Results: Fetal kidney glomerulus histology is different from adult. Unlike in adult kidney, foetal kidney glomerulus shows many developmental stages as v, c, s, cresentric in starting phase. Multiple rows arrangement in between medullary rays with well developed mature glomeruli at juxtamedullary junction. Capillary invagination with developed Juxta glomerular apparatus was appreciated. Nephrogenic zone which was found as broad band in early gestational weeks disappeared near term. Conclusion: The present study will be helpful in understanding the normal histological architecture of foetal kidney glomerulus and add to the existing knowledge regarding development of foetal kidney, its relation with gestational age and pathogenesis.

Deep space neck infections (DNI) are common pediatric illnesses, which can lead to significant morbidity and healthcare expenditures. Recent studies suggest that the incidence of pediatric DNI in the United States is increasing, but no nationally representative studies exist. This study sought to characterize pediatric DNI at the national level over the past decade and to determine whether U.S. incidence of pediatric DNI and associated resource utilization changed from 2000 to 2009.The Kids' Inpatient Database (KID) was used to evaluate pediatric DNI incidence, demographics, and outcomes from 2000 to 2009. Cases were identified using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnostic codes for peritonsillar abscess (475), parapharyngeal abscess (478.22), and retropharyngeal abscess (478.24). Regression analyses within each year and across the entire study period were performed on variables of interest including performance of imaging studies, operative intervention, length of hospital stay and total hospital charges.The incidence of retropharyngeal abscess increased significantly from 0.10 cases per 10,000 in 2000 to 0.22 in 2009 (p = 0.02). There was no significant change during this time period in the incidence of combined DNI (1.07–1.37 cases per 10,000, p = 0.07), peritonsillar abscess (0.82–0.94 cases per 10,000, p = 0.12) or parapharyngeal abscess (0.08–0.14 cases per 10,000, p = 0.13). The percentage of retropharyngeal abscess patients managed surgically decreased (48–38%, p = 0.04) and the average length of hospital stay also decreased during this time (4.6–3.9 days, p = 0.03). There was a marked increase in the total inflation-corrected hospital charges per case for all DNI ($9,486–16,348, p = 0.005).The incidence of pediatric retropharyngeal abscess has increased significantly from 2000 to 2009, without concurrent increases in the incidence of combined DNI, peritonsillar, or parapharyngeal abscesses. There has been a change in management of retropharyngeal abscesses during this time with a decrease in operative intervention and a decrease in the length of hospital stay. Hospital charges associated with all pediatric DNI have nearly doubled during this timeframe, warranting future epidemiologic resource utilization studies in this population.

A female foetus of 3.23 kg was delivered by a primigravida of 23 years, after scanning by ultrasound, depicting findings of oligohydramnios and congenital abnormalities. The foetus showed bilateral Polydactyly (six digits) in both upper and lower limbs, polycystic enlarged bilateral kidneys, anencephaly, hypoplastic lung, small heart, deformed liver etc. The deformed foetus appeared to be the product of multifactorial inheritance disorders in sequential manner where survival of the foetus could not be possible beyond a period.

Vermiform appendix is characterized by great variability of its location & morphology. It has diverse anatomical positions, lengths and conditions of mesoappendix and limited information is available on developmental morphology & morphometry of fetal vermiform appendix. Since the appendix develops during descent of colon, its final position frequently is posterior to the caecum or colon that is retrocaecal or retrocolic respectively. The present study aims to locate the situation and growth of vermiform appendix at different gestational ages of fetuses. Thirty eight human fetuses (n=38) of 11-40 wks gestational ages were procured from Dr. Sushila Tiwari Memorial Hospital, Haldwani. Fetuses were dissected and the position, length & width of appendix, length of mesoappendix were recorded in situ. The location of appendix in relation to abdominal regions presented higher incidence of subhepatic position in less than 30 weeks fetuses and right iliac fossa position in more than 30 weeks fetuses. Length and width of appendix increases with increase in gestational age. Mesoappendix was not extended upto tip of appendix in most of fetuses. The observations are in favor of developmental process on the localization of vermiform appendix.

The unique architecture of the spleen enables it to play a key role in the interactions between the circulatory, reticuloendothelial and immune systems. Response to circulating antigens in the setting of infection, autoimmune disease or other conditions may result in a range of benign lymphoid proliferations. Moreover, patients with underlying immune deficiency may also show abnormal lymphoid proliferations within the spleen. This review will highlight the histologic, immunophenotypic and clinical features of reactive lymphoid proliferations to aid in their recognition and provide a context for understanding their development in relation to normal splenic structure and function.

History reveals that the practical learning of Anatomy with the help of Human dissection has passed through various phases with ups and downs. Diocles of Carystus had dissected human fetus in 380 B.C. and he used the word Anatomy in his writings. Hippocratic school described the suture lines in the skull and gave the anatomical information of the shoulder region in 400 B.C. This is a clear testimony that Hippocratic school must have examined the human body, otherwise such description would have not come in the literature (Gardner et al 1965)

Background : Placenta along with its umbilical cord is a vital organ for maintaining pregnancy and promoting normal foetal development. Foetal outcome can be adversely influenced by pathological changes in placenta and also by the variation in the site of attachment of umbilical cord. Aims and Objectives : To study the incidence of furcate umbilical cord insertion over placental chorionic plate in normal full term pregnancy. Materials and methods : This study was conducted in the department of Anatomy Government Medical College Haldwani. 100 freshly delivered placentae were collected from Dr. Sushila Tiwari Government hospital Haldwani. The sample was further categorized according to the parity of mother into two groups primipara (n=39) and multipara (n=61). Placentae included in the study were obtained from full term pregnancy without any complication like diabetes, hypertension etc. Results : The incidence of furcate umbilical cord in the present study was 2.6% in primipara group and 3.3% in multipara group. Conclusion : Variation in the site of insertion of umbilical cord are thought to result from process known as “Trophotropism” in which the chorionic frondosum or the early placenta migrates with advancing gestation to ensure better blood supply from more richly vascularised area. The overall incidence of furcate cord in this study is 3%. We have noticed one furcate cord (2.6%) in primipara group (n=39) and two furcate cords (3.3%) in multipara group (n=61). The neonates delivered were perfectly healthy without any evidence of congenital anomalies.

Congenital absence of left thumb with deformities of carpal bones in a twin born adult woman is reported here. The subject is the only surviving twin aged forty years reported to the hospital with a complaint of weakness of left hand. On examination, left hand did not possess the thumb and appeared to be less muscular. A single prominent crease like Simian crease was noticed on the left palm without other features of Down’s syndrome. No radial pulse was palpable on the left side at its usual position on the wrist. Associated developmental anomalies of carpal bones and radius on left side were noted in radiograph: Scaphoid and lunate were shortened. Trapezoid was absent. Metacarpals were shorter and lower end of the radius was less expanded when compared to right side. Genetic disorders associated with twin pregnancy might have resulted in the absence of left thumb. Orthopaedic surgeons should be aware of these associations to avoid complications during surgery.