Introduction: Spleen is the largest lymphatic organ present in the upper part of the abdominal cavity. In fetal life it is a haemopoietic organ while it destroys blood in the postnatal life. It filters the blood from blood borne antigens and microorganisms. The present study was conducted to describe the detailed histological changes of human fetal spleen during its development. Materials and Methods: The present study was a prospective, observational study conducted in the Department of Anatomy along with the Department of Obstetrics and Gynaecologyat a tertiary care teaching hospital situated in Uttarakhand state from March 2021 to July 2023. Human fetuses between 13 to 40 weeks of gestational age and without any congenital malformations were collected after routine medical termination of pregnancies, still birth or intra uterine death for study. Results: The microscopic anatomy of the spleen was observed at different gestational ages. During first trimester of pregnancy primary vascular system was seen. Formation of red pulp and white pulp was seen clear during second trimester of pregnancy. At the beginning of the third trimester, white pulp shows lymphatic nodule with eccentrically placed arteriole. Conclusions: The detailed study of development of fetal spleen suggest the functional aspect of spleen in fetal life. Keywords: Microscopic anatomy, Spleen, Histogenesis, Fetal autopsy, Embryology

Introduction: The spleen, a crucial lymphoid organ, plays a significant role in blood cell production and regulation. Emerging from mesodermal cells in the dorsal mesogastrium during the fourth embryonic week, the spleen is located in the left upper quadrant alongside the tenth rib. This study investigates morphological variations in human fetal spleens, serving as blood filters and storage sites for iron, erythrocytes, and platelets. This study aimed to assess morphological measurements of human fetal spleen development. Materials and Methods: Sixty formalin-preserved fetuses (33 male, 27 female) of varying gestational ages were examined over a three-year period (2020-2023) at the Anatomy Department, Govt. Medical College Srinagar Garhwal, ensuring adherence to ethical guidelines. Gross characteristics such as position, shape, relations, notches & fissures, and ligaments were assessed and statistically analyzed. Results: All fetal spleens were located in the left hypochondrium, with 50% exhibiting a wedge shape. The stomach consistently associated with the spleen, while no relationship was observed between the kidney, left colic flexure, and spleen in early fetal stages. The liver exhibited connections with the fetal spleen. Notches were most prevalent along the superior border, followed by the inferior border and lateral pole, with 27 spleens showing fissures. Conclusions: Studying prenatal spleen development aids in understanding organ pathologies, thereby enhancing diagnostic and preventive techniques. Keywords: Fetal Spleen, Wedge Shape, Notches, Fissures

Introduction: A cross sectional study was conducted to observe morphological and developmental changes occurring in thymus gland at various gestational age among human fetuses. The morphometric measurements of thymus is useful in calculating size as intrauterine growth retardation (IUGR) and cellular immune deficiency of infant is associated with a significant decrease in fetal thymic size. Materials & Methods: This study was carried on medically aborted and stillborn fetuses (n=31; F=21, M=10), which were obtained from Dr. Sushila Tiwari Memorial Hospital, Haldwani, (Uttarakhand,) with due consent of parents. Fetuses were preserved in 10% formalin. Thymic gland was dissected out to observe its weight, length and thickness. Results: Thymus glands were located in superior mediastinum. On gross examination, they were of greyish pink to greyish brown in colour. Most of the glands were bilobed and few were irregular in shape. There was progressive increase in all morphometric dimensions of thymus in relation to gestational age. Growth of right lobe of thymus was comparatively more than of left lobe. Conclusion: Thymic morphometric parameters in relation to gestational age can be used as reference values in imaging studies in the prenatal and in initial perinatal stages, so we could compare the normal morphology with that of in IUGR and immune deficiency.

Background The aim of the study was to assess the morphological and histological features of accessory spleen in formalin-preserved human fetuses. Methods The study was conducted on spleen of 40 human fetuses of varied gestational ages without any congenital anomalies with due clearance from the ethical committee. The existence of accessory spleen was investigated during dissection. These were then dissected, weighed, and stained by hematoxylin and eosin as well as Masson’s trichrome method and observed under compound light microscope. Results In 5 (12.5%) cases, the accessory spleen was revealed in fetuses aged between 29th and 40th gestational weeks. These were located near the splenic hilum. On histological examination, the tissue of accessory spleen revealed a well-defined capsule. White pulp was less differentiated as compared with red pulp area. Conclusion The accessory spleen is often misdiagnosed by the clinicians for neoplastic growth or lymph node enlargement; therefore, its awareness is important.

Background Anatomical knowledge of bony bridges around the foramen ovale may be helpful for diagnostic and invasive neurosurgical procedures like electroencephalogram analysis, trigeminal rhizotomy, biopsy of cavernous sinus tumors, and mandibular nerve block. Lateral pterygoid plate forms an important landmark for mandibular anesthesia; therefore, any variation related to lateral pterygoid plate is likely to create confusion during the maneuver of anesthesia. Aims and Objective The aim of the study was to explore any bony obstacle within and around Foramen ovale. Obstacles in form of ossified complete or incomplete ligaments. Additional foramina formed by ligaments or any bony enlargement might disturb the structures passing through the Foramen ovale. Methods Around 530 dried crania (from medical colleges in Uttarakhand and Uttar Pradesh) were observed to find ossified ligaments and foramen formed by them. Crania associated with bilateral enlarged lateral pterygoid plate other than the average width of 1.5 cm were included in this study. Length of ligaments and width of pterygoid plate were measured by digital Vernier calipers. Results Out of 530 crania, unilateral 52 ossified pterygospinous ligament (incomplete 31 and complete 21) were observed. Among them some rare variation was found along with ossified pterygospinous and pterygoalar ligament, one cranium along with unilateral pterygospinous bar was also having bar within foramen ovale, forming an accessory osseous compartment, found to be rare kind of variation. Another unilateral complete pterygospinous bar was enclosing two foramens instead of one. Only single cranium was found to have pterygoalar bar, related medial to foramen ovale. One cranium was associated with bilateral enlarged lateral pterygoid plate (i.e., 2.5 cm) was also found to be obliterating the space, that is, retropharyngeal and parapharyngeal space for surgeons. Conclusion This study would provide the anatomical knowledge of these bony bridges around the foramen ovale and may be helpful for diagnostic and neurosurgical procedure like microvascular decompression by percutaneous trigeminal rhizotomy for trigeminal neuralgia, percuatneous biopsy of cavernous sinus tumor and mandibular nerve block by lateral subzygomatic route. Thus, lateral pterygoid plate forms an important landmark for mandibular anesthesia.

BACKGROUND Multiple Choice Questions (MCQs) are widely used for evaluations of knowledge for many professional courses including Medicine. Construction of appropriate test items is a challenge in preparing quality multiple choice questions. Item analysis provides valuable feedback data on validity of multiple-choice questions. Aim- The present study was conducted to evaluate the Difficulty Index (DIF-I), Discrimination Index (DI) and Distractor Efficiency (DE%) of the multiple-choice questions (items) of previous postgraduate medical entrance examinations. MATERIALS AND METHODS A list consisting of 50 MCQs was taken from standard question bank (memory based) of Physiology, usually followed by postgraduate aspirants and administered to undergraduate students (n = 97). The result of student's performance in these MCQ based unit test was entered in MS Excel 2007. Each item was analysed for three parameters: Difficulty Index, Discrimination Index and Distractor Efficiency. Study Design- Observational cross-sectional study. RESULTS In the present study, after analysis of data 28% of the MCQs were difficult, 20% were good, 26% were excellent and 26% were easy with Difficulty Index. 58% were excellent and 10% were good with Discrimination Index. 46% had at least one non-functional distractor. CONCLUSION Item analysis of MCQs of postgraduate entrance examinations demonstrated that Difficulty Index was neither too high nor too low. Discrimination Index was high, and Distractor Efficiency was good. Hence, we proposed that for formation of appropriate test items, question bank in the form of quality MCQs with negative marking should be prepared and their post validation, data to be collected.

Introduction: The Lipid profile is found to be abnormal in postmenopausal women as compared to their premenopausal counterparts. Study objectives were to know about the relationship of lipid profile and menstrual cycle different phases. Material and methods: The hospital based cross-sectional study was carried out on total (n=161) healthy women in different phases of menstrual cycle. Results: The changes in the lipid parameters like total cholesterol, Triglyceride, VLDL, LDL, HDL and AI is found to be highly significant among the various age groups of women. Conclusion: The lipid profile becomes abnormal as the women approaches perimenopause, postmenopause as compared to their normal menstrual cycle pattern.

The elbow joint is a compound joint made of articulations in between the humerus, ulna and the radius. The coupling areas (joints) are of prime importance from the kinetic-biomechanical perspective and of potential inter-ethnic significance. These articulations can be affected by several pathologies that may require medical and surgical interference. This experimental analysis aims to infer data in relation to the morphometry of the proximal segment of the ulna and its articular surfaces represented by the greater sigmoid notch (trochlear notch) and lesser sigmoid notch (radial notch).A sample of fifty ulnae (n = 50, 27 right and 23 left) was studied in connection with; the surface area of the sigmoid notches (SA), weight of ulna, and the volume of proximal portion of ulna (including the olecranon process and reaching inferiorly to the lowest margin of the radial notch), the length of ulna (L). Longitudinal dimensional parameters were also studied including; the straight distance between the highest point (tip) of the olecranon and that of the coronoid process (OCD), and the mid-olecranon thickness in mediolateral (T1) and anteroposterior orientation (T2).It has been inferred that there were no significant differences in between right versus left ulnae and in relation to the majority of morphometric parameters with an exception for OCD (22.47 vs 20.75, p-value = 0.002). There was a positive correlation in between all the parameters, although the strongest associations were observed in between OCD, the area of the trochlear notch, and the weight of ulna.A precise conclusion was reached in relation to morphometry, volumetry and the pertinent biomechanics of the proximal segment of the ulna. Key findings are of value to biomedical engineers, medical professionals including orthopaedic surgeons and rheumatologists, evolutionary biologist, and physical anthropologist. Data from this study can be used to (reverse) engineer the perfect implant for the elbow joint.

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.

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.

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.

Background and aim: The anatomical variations of fissures and lobes of lungs have been described by many research workers on CT scans, whereas, there were fewer studies done on gross anatomical specimens. Materials and methods: In the present study, 30 embalmed cadavers have been dissected and lungs were examined for fissures and lobes. Results: Nine out of 30 left lungs showed incomplete oblique fissures. Eight out of 30 right lungs showed incomplete transverse fissure but oblique fissure was complete, and in two right lungs, incomplete oblique and transverse fissures were found. In one cadaver one accessory lobe and one accessory fissure was present, on right side. Comparative analysis of present work with data in literature suggest that different studies performed on radiological images reported greater prevalence of incomplete or absence of pulmonary fissures as compared to present cadaveric study. Therefore our findings with regard to fissures and lobes are different from many studies but are approximately similar to two. Conclusion: Variation of lung anatomy is important for cardio-thoracic surgeons, radiologists for interpreting x-rays, CT scans and MRI and also it is of academic interest to all medical persons.

Study of skulls has attracted the attention of anatomists since ages and sporadic attempts have been made to study skulls from time to time. Talking about the pterygoid processes of sphenoid bone, the irregular posterior border of lateral pterygoid plate usually presents, towards its upper part, a pterygospinous process, from which the pterygospinous ligament extends backwards and laterally to the spine of sphenoid. This ligament sometimes gets ossified as pterygospinous bar and a foramen is then formed, named pterygospinous foramen, for the passage of muscular branches of mandibular nerve. The present study was undertaken to observe the incidence and status of pterygospinous bony bridge and foramen, its variations, and clinical relevance in the adult human skulls of North India. For this purpose, 500 skulls were observed, belonging to the Anthropology Museum of Department of Anatomy, GSVM Medical College, Kanpur. Pterygospinous bars were found to be present in 51 skulls (10.2%), out of which completely ossified pterygospinous bony bridges were present in 20 skulls (4%) while 31 skulls (6.2%) had incompletely ossified pterygospinous ligaments. Such variations are of clinical significance for radiologists, neurologists, maxillofacial and dental surgeons, and anaesthetists, too.

Developmental anomalies of the Mullerian duct system represent some of the most fascinating disorders that obstetricians and gynaecologists encounter. The uterus is formed during embryogenesis by the fusion of the two paramesonephric ducts (Mullerian ducts). This process usually fuses the two Mullerian ducts into a single uterine body, but fails to take place in the affected women who maintain their double Mullerian systems. A bicornuate uterus is a type of a uterine malformation where upper part of uterus forms two horns. The fusion process of upper part of Mullerian duct is altered. As a result, cranial part of the uterus becomes bifurcated. As Mullerian duct anomalies are of anatomic interest, this article discusses epidemiology, embryological development, genetics of development and malformation and lastly various classifications based on Mullerian duct development. Pregnancy in bicornuate uterus is usually of high risk with reproductive outcomes like recurrent abortions, preterm delivery or malpresentation. Classifying Mullerian duct anomalies bears merit because it correlates anatomic anomalies with arrests in morphogenesis. Establishing an accurate diagnosis is essential for planning treatment and management strategies.

This study was carried out to estimate the relationship between foot length and stature using simple linear regression analysis based on a sample of male and female adults of Uttarakhand Region. Measurements of foot length and stature were taken from 125 adults (62 male, 63 female) aged 17–24 years. The participants were students of the UFHT Medical College, Haldwani of Kumaun University, Nainital. Obtained data was analysed and attempt was made to find out correlation between foot length and height of an individual. A good correlation of height was observed with foot length and it was statistically highly significant. The results of the present study would be useful for Anthropologists and Forensic Medicine Experts.