Indian Journal of Anatomy

Introduction: In today’s advanced medical world maternal child health care the important part of the healthcare system and important components is estimation fetal gestational age. Gestational age is age of unborn baby, defined in weeks as beginning from first day of last menstrual period prior to conception. Trimester is period of three calendar months during a pregnancy. Radiologically the period of gestation is grossly divided into three trimesters. Estimation of gestational age and thereby forecasting Expected Date of Delivery (EDD) is not only concern of the Individual but it is invaluable in the diagnosis of intrauterine growth retardation of fetus and obstetric planning. Hence we proposed the present study to evaluate fetal Head Circumference for measuring the gestational age. Materials and Methods: The study Correlation between gestational age and head circumference in second trimester was carried out at Govt. Medical College and Hospital, Nanded, between July 2011 to July 2013 period. The study included 150 pregnant women the data so collected was then subjected to statistical analysis by expert statistician with the help of SYSTAT Crainsoft version 12 software. Standard statistical methods, parametric methods were used for the evaluation and significance. Results: Variation in fetal growth on the basis of Head Circumference during second trimester can be explained to the extent of 96.65%. The value of R is highly significant (Student’s ‘t’ test value = 149.10, p < 0.0001, highly significant) showing that there is statistically positive correlation between gestational age and Head Circumference. Conclusion: From the present study it is found that Head Circumference and gestational age are statistically highly significant. The regression equations derived for growth parameter for estimating gestational age in a normally developing fetus, increase with gestational age, showed good correlation with gestational age. In Present study, Head circumference is the sensitive parameter and results of present study were comparable with previous studies.

Keywords: Age; Fetal; Gestational age.

Suprascapular notch harboring the two ligaments, namely superior transverse scapular ligament and anterior coracoscapular ligament is a potential site contributing in causation of suprascapular nerve entrapment syndrome. The etiological role of superior transverse scapular ligament in suprascapular nerve entrapment syndrome is established and it needs to be excised in the treatment of suprascapular nerve entrapment syndrome. The anterior coracoscapular ligament is recently introduced as a new risk factor. The mystery about the role of this ligament in suprascapular nerve entrapment syndrome attracted us to undertake morphological study of this ligament. In this study, anterior coracoscapular ligament was found as a separate fibrous band in 41.2%. According to the distal attachment of the ligament as suggested by Piyawinijwong, we found three types of anterior coracoscapular ligament: type I (52.4%), type II (40.5%) and type III (7.1%). According to the shape of ligament, we found anterior coracoscapular ligament as– Fan shaped (47.6%), band shaped (42.9%), bifid (2.4%) and vestigial type (7.1%). The mean cross sectional area of suprascapular opening with anterior coracoscapular ligament was estimated as 29.86 mm2 and without anterior coracoscapular ligament it was 29.35 mm2. The mean middle width of suprascapular opening with anterior coracoscapular ligament was 3.8 mm and without anterior coracoscapular ligament it was 4 mm. The suprascapular nerve as the only structure passing through suprascapular opening was seen in 50%. The suprascapular nerve along with suprascapular vein passing through suprascapular opening was seen in 20.6% whereas suprascapular nerve and suprascapular vessels passed through suprascapular opening in 17.6%. Accessory suprascapular veins were found in 11.8%. The anterior coracoscapular ligament apparently contributes to reduce the area of suprascapular opening leading to compression of suprascapular nerve which may cause suprascapular nerve entrapment syndrome. The anterior coracoscapular ligament if present is one of the equally important predisposing factors as superior transverse scapular ligament. Variations in morphology of anterior coracoscapular ligament may influence the area of suprascapular opening through which suprascapular nerve passes. Therefore one should not underestimate the importance of anterior coracoscapular ligament.

Keywords: Anterior coracoscapular ligament; Suprascapular nerve entrapment syndrome.

Background: The Neck Shaft Angle axis of the shaft and axis of neck of femur.the angle is also named as caput collum diaphysis or cervico diaphyseal angle. Anthropometric skeletal measurements are used to show regional diversity between different populations or even within the same population. Moreover, skeletal measurements and shape of the bones can offer a guide to clinicians for determining the risk factors for fractures. Aim: The present study was undertaken to analyse femur neck shaft angle in kolar population. The standard commercially available marked prosthesis sometimes may not be the best fit to the Indian patients because of wide anatomic variation which leads to complications due to mismatch like aseptic loosening, improper load distribution and discomfort. Set up: Department of anatomy, Sambhram Institute of Medical Science and Research. Study Design: The present study is a cross-sectional observational study. Materials and Methods: The materials for the present study comprised of 100 (50 right side and 50 left side adult dry femora. Neck shaft angle was measured with help of goniometer in degrees. Mean and standard deviation were calculated. The student t-test was applied and side wise comparison was done by a two-tailed student t-test. A level of significance of 5 percent (p < 0.05 ) was used for all analysis. Results: No significant side difference is noted in Neck Shaft Angle in degree on comparing both sides. Range of Neck Shaft angle on right side is 120–138° Range of Neck Shaft angle on left side is 122–137°, p-value 0.21–not significant. Mean neck shaft angle of both the sides is 128.51° Conclusion: The values obtained were greater in western world than in present study, there is regional variation among different regions of India. This study will encourage the biomechanical engineers to design and manufacture implants with a correct morphometric data to suit our Indian population and for an improvised surgical outcome with prevention of complication.

Keywords: Kolar; femur; neck shaft angle; implants.

36 adult non-pathological dried mandibles were studied. Distance between Mental Foramen (MF) and symphysis menti on both sides was measured and compared. Mean value of right side were 27.2 mm ( SD ± 0.28) and mean value of left side was 26.3 mm ( SD ± 0.35) ‘t’ test value was 15.0 and ‘p’ value was highly significant ( p < 0.01). Distance between MF and lower border of body of mandible was measured on both sides and compared, mean value of right side was 14.2 ( SD ± 0.14) and left side was 13.2 ( SD ± 0.26) ‘t’ test value was 19.5 and ‘p’ value was highly significant (p < 00.1). The distance between MF and posterior border of ramus of mandible was measured and compared. Mean value of right side was 9.2 (SD ± 0.21) and mean value of left side was 70.2 (SD ± 0.15), ‘t’ test value was 22.5 and p value was highly significant (SD ± 0.01) All these measure me were taken by vernier caliper. Mandible form the oor and cavity for tongue, the carcinoma of tongue also spread to body and ramus of the mandible moreover during accident chin or symphysis menti was commonly fractured. Hence these parameters will be quite useful to maxilla-facial surgeon to preserve the mental nerve which is sensory supply to lower lip, the buccal mucosa from incisor to the premolars and skin over the chin. Mental nerve also carries chorda tympani to labial minor salivary glands.1 It is also useful anesthetist to give local anesthesia invasive procedure for buccal or oral surgery. Moreover, these parameters belong to adult mandible who are more prone to meet accidents.

Keywords: MF = Mental foramen; ramus; body; symphysis menti; venier caliper.

Tattooing is gaining more importancein modern society, and the speed is picking up faster. And its popularity is not restricted to only one gender especially in adulthood. Aim: To assess the Psychotic symptoms in tattooed individual. Methodology: We conducted a cross-sectional descriptive study using Brief Psychiatric Rating Scale (BPRS). Results: Results are depicted in the table with the majority of statistical significance. Discussion: Tattooed individuals may have the psychotic symptoms earlier to getting the tattooed done or may develop the psychotic symptoms after getting the tattoo, which was not very much clear in this present study. But definitely, these tattoos are related with the use of substances which causes the psychotic symptoms. Conclusion: As there is a definite correlation between the use of the substances and having a tattoo. This could be used in the form of signs for understanding the other substance user. And literature review confirms the use of the substance with psychotic symptoms. In the same way, tattooing also indicates the existence of the psychotic symptoms.

Keywords: Symptoms; Psychosis; tattoo.

32 male cadavers were selected to study the variation of bifurcation of brachial artery. Measurement were taken from (a) tip of the Acromion process of scapula to tip of the middle finger (b) Position of brachial artery was measured from epicondyle of humerus to the point of bifurcation of brachial artery. All the measurements were taken by tailors tape. The mean value of length right upper limb was 73.66 (SD ± 0.38) and mean length of point of brachial artery from epicondyle of Humerus was 4.29 (SD ± 0.01) and mean value of length left upper limb was 73.61 (SD ± 0.35) and point bifurcation of artery mean value was 4.28 (SD ± 0.02), correlative co-efficient study of upper limb was 0.73, ‘t’ test value was 5.8 and ‘p’ value was highly significant (p <0.01) of left limb was 0.84 ‘t’ test value was t.84 and p value was highly significant (p <0.01). This study was quite helpful to orthopedic surgeon, physician to predict the point of bifurcation by knowing length of upper limbs and vice versa, so that they can preserve the brachial artery and its branches and take proper use like pulsation or recording blood pressure.

Keywords: Brachial artery; Olecranon process; Acrimony process.

Introduction: Assessment is crucial to the educational process, and is useful that in assessing the knowledge. At under graduate level there are three domains of skill to be evaluated, a cognitive, affective, and psychomotor. The written assessment are to be done with the help of MCQ, SAQ, LAQ (open ended) essay writing. Aims: To assess the preferences of undergraduate medical student among the three formats of written assessment: LAQ, SAQ and MCQ. Settings and Designs: A cross sectional study was conducted on 100 students of first MBBS for the duration of four month from December 2016 to March 2017 at BJGMC. Pune. After the completion of lecture series exam was conducted and performance was assessed. Statistical analysis done and percentage was calculated. Results: 90% students would like to have MCQs in their regular exam. Student with strong factual and recalling ability, they opted for the MCQs. But the students with strong analytical or interpretative skill and those can apply knowledge they opt out for SAQ and LAQ. Conclusion: It should be combination of various methods and techniques assessment is based upon purpose of evaluation at various levels in the form of skill, knowledge and understanding.

Keywords: Assessment; Learning; Medical education.

Introduction: The anatomy of the acromion varies considerably from individual to individual, and certain acromial shapes have been associated with an impingement syndrome. Neer’s theory of impingement was further boosted by Nicholson who stated that a higher incidence of rotator cuff tears was present in patients with Bigliani Type III acromion (Hook Type). Objectives: (1) To study the morphometric features of acromion process of scapula (Type, Tength, Tidth and Thickness). (2) To compare the morphology of acromion process and morphology of scapula with those of previous studies. Materials and Methods: The study includes 60 dry scapulae out of them, 30 are of right and 30 are of left side. Only bones with clear and intact features were used for the study while damaged scapulae were excluded. The bone belongs to mature specimens, but the exact ages and gender of the specimens were not known. Descriptive statistics and correlation were calculated using SPSS 20 version. Results: The mean length, width, and thickness of acromion process of scapulae were 41.4 mm, 24 mm and 8.2 mm respectively. We found Type I and Type II acromion process were more in the Telangana region i.e., 46.66% and 38.34 % respectively. The Type III acromion process were 15%. Conclusion: In the present study we found Type I and Type II acromion processes were more in number in the Telangana Region with a very low incidence of Type III acromion process.

Keywords: Neer’s theory of impingement; Bigliani Type III acromion.

Objectives: According WHO increased BMI is major risk factor for major non communicable diseases like Diabetes Mellitus, Heart diseases, Some form of cancers etc. prevalence of obesity has increased significantly in past few decades. WHO considers BMI as important parameter to assess the degree of obesity. Our present study was aimed to study other better way to assess the Obesity which is a better indicator than BMI. Materials and Methods: Present study was conducted on 130 subjects of 18 years of age, of both sexes, of these 80 subjects were non-obese females and 50 were non-obese males. This study was conducted in the department of anatomy, GSL Medical College, Rajamahendravaram, AP by using body composition monitor (model-BHF-362, KARADA SCAN). Results: On analyzing the results it is found that body fat percentage in females is significantly more (p-Value < 0.0001) when compared to male subjects of same age and almost equal BMI (mean BMI 23.08 and 23.48). Significant difference was also found in the regional distribution of Fat. Conclusion: As there is significant difference in body fat% and its distribution among males and female subjects, body fat percentage should be consider for assessment of degree of obesity rather than BMI.

Keywords: Obesity; BMI; Body fat Percentage; Body composition monitor.

Tricuspid valve complex is commonly involved in various heart diseases like rheumatic heart diseases, congenital cardiac anomalies etc. Studies on Tricuspid valve complex, in Maharashtrians are few; so the present work was undertaken. Thirty five formalin fixed embalmed adult heart obtained by dissecting cadavers allotted to undergraduate students in GMC, Aurangabad, were studied irrespective of gender and cause of death. In present study circumference of tricuspid valve annulus was (mean +/- SD) 10.96 +/- 1.36 cm with range 8.6 cm to 13.6 cm; Diameter at minimum separated points (D1) was in the range of 2 cm to 3.5 cm and diameter measured at maximally separated points (D2) were in range 2.8 cm to 4.4 cm. Occurrence of papillary muscle was noted, anterior and posterior papillary muscle were present in all specimens however septal papillary muscle was absent in 9 out of 35 specimens. Anterior papillary muscle dimensions were noted; mean length for it was 1.224 cm +/- 0.478 cm with range 0.4 cm to 2 cm and mean thickness was 0.488 cm +/- 0.182 cm (range 0.3 cm to 0.9 cm).Knowledge of anatomy of tricuspid valve complex bears importance for operative procedures on tricuspid valve abnormalities. Present study data might be useful for cardiothoracic surgeons for newer surgical techniques like papillotomy, correction of papillary rupture induced tricuspid regurgitation.

Keywords: Anterior papillary muscle; Tricuspid valve.

Background: Standard anatomy textbooks describe accessory obturator nerve (AON) as small arising from ventral branches of third and fourth lumbar ventral rami. It descends along medial border of psoas major, the accessory nerve emerges from the medial border of the psoas muscle and travels parallel but 2–3 cm ventrolateral to the main nerve. It reaches the thigh by crossing the superior pubic ramus behind the pectineus muscle and then divides into several branches. One branch directly innervates the pectineus, another joins the anterior division of the obturator nerve, and a third conveys sensory input from the hip joint. AON is still under recognized and its presence has great clinical consequences for lumbar plexus blockade. The presence of the AON leads to incomplete anesthesia during obturator nerve block, thus unable to achieve painless hip joint surgeries. The AON may also contribute to continued adductor spasm despite ON blockade. Misidentification of the nerve can also lead to injury. Objective: Looking to the applied anatomy of AON and its anatomical variability, we planned to study the detailed anatomy of AON in human cadavers. Methods: Permission from the Institutional Ethical Committee was obtained before starting the project. We have carried out thorough dissection of lumbar plexus in forty-six cadavers bilaterally. Only one male cadaver had a large retroperitoneal mass distorting the anatomy of concerned region on right side, was excluded from the study. The fibers of psoas major were then meticulously dissected at their origin from the lateral surface of the lumbar vertebra and the accessory obturator nerve was traced till its roots at the intervertebral foramen. The course and branches of AON was carefully recorded. Results: AON was observed in 29 of 91 cases (31%) of cases. Most commonly the AON was forming from the ventral rami of L3 and L4 but in cases AON was taking origin from the trunk of obturator nerve. The branching pattern of AON was variable: AON was connected to obturator nerve in 20 (21%), to anterior branch in 30 (31%) and to posterior branch in 4 (5%) of cases in present study. Pectineus muscle was solely supplied by AON in 13 (14%) specimens. Conclusion: The presence of AON is clinically important as it is also considered during ON blockade. The AON blockade can be indicated in superficial surgeries of thigh, treatment of pain due to thigh tourniquet, as a diagnostic aid for pain syndromes in the hip joint, inguinal areas or lumbar spine, and in relief of intractable hip pain due to osteoarthritis. These anatomical details of AON will help anesthetists, orthopedic surgeons, neurophysicians to perform safe and uncomplicated procedures.

Keywords: Accessory obturator nerve; Obturator nerve block; Branches; Anesthetic; Orthopedic surgeon.

Background and Objectives: Identification of sex, age, race and stature is the most important aspect of any forensic investigation.There is a strong correlation of stature with hand dimensions and if either of the measurements is known, the other can be calculated. With this objective, the present study was designed to correlate the hand dimensions with stature of an individual and to record the standard deviation in the estimation of stature. Methodology: This cross-sectional study was conducted amongst 1000 participants (500 Male and 500 Female) of ESIC Institute Gulbarga over a period of 14 months. Hand dimensions along with stature and weight were measured. Linear regression co-efficient was calculated. Results: Mean stature was 161.88 cm. Mean hand length was 18.11 cm on right side and 18.10 cm on left side. Mean hand breadth was 9.91 cm on right side and 9.83 cm on left side. Conclusion: Highly significant difference in right and left side mean hand length and breadth measurements was observed. Also observed was a strong positive statistically significant correlation between height and hand dimensions. This data might be useful for forensic, epidemiological and anthropometric studies where stature determination is of utmost importance.

Keywords: Dimensions; Human stature; Hand length; Hand breadth; Correlation.

Background and Objectives: Forensic investigation necessitates estimation of age, sex, stature and weight of human individual. Researchers all over the world studied various human parts in different ways. Both halves of human body are fairly symmetrical. It is assumed that each body part is having some relation with other part. Present study was conducted with the aim to study the relationship between hand and foot dimensions. Methodology: This cross-sectional study was conducted amongst 1000 participants (500 male and 500 female) of ESIC Institute Gulbarga over a period of 14 months. Hand and foot dimensions were measured. Results: Significant correlation was observed between hand and foot dimensions in both sexes and on both sides. Correlation co-efficient ‘r’ and Linear regression equation was calculated. Interpretation and Conclusion: Statistically significant correlation was observed between hand and foot dimensions of both side sin both sexes. This data would be useful for forensic investigations and anthropometric studies.

Keywords: Correlation; Hand Length; Hand Breadth; Foot Length; Foot Breadth; Linear Regression Coefficient; Crime.

Background: Scapula is one of the important components of shoulder girdle. According to clinical experts several shoulder pathologies found to have an anatomical basis. The scapula is one of the bones found to present several variation based on race, sex, and region. Thus the osteometric measurements and morphometric knowledge of the scapula is essential to understand normal anatomy, for comparative anatomy, to treat different shoulder disorders and also for manufacturing of prosthetic products. Aims and Objectives: To obtain the baseline data of morphometric measurements of dry human scapula among South Indian Population. To compare the clinical importance of obtained parameters with anthropometric studies done by other authors. Materials and Methods: The following study was conducted on 105 dry adult human scapula obtained from the students of first MBBS. The measurements was taken using digital vernier calliper and obtained data was statistically analysed using student ‘t’ test using SPSS version 20. Results and Conclusion: The anthropometric measurements of the adult dry human scapula among South Indian Population are reported in this paper. This data could be of helpful for surgeons, anthropologists to understand the normal anatomy of scapula which play an important role in the management of different shoulder pathologies, rehabilitation of shoulder injuries, contribute to demographic studies, and also assist in forensic cases.

Keywords: Shoulder; Scapula; Girdle; Morphometric; Injury.

Introduction: As a part of anatomy teaching curriculum and three-dimensional demonstrations in Osteology, preparation of bones plays an important role. Also, to bring more information regarding sites of muscular attachments and course of neurovascular structures in a region, study of bones consistently maintains its own essentiality. Osteology is an important aspect of forensic anatomy too. This study is to know the effective techniques in bone cleaning among the various methods like maceration with water, boiling, enzymes, chemicals, bugs, leaving open above ground and burial under soil. Methods: Dissected cadavers buried for a period of about one year were dugout for the skeleton. Bones were also collected from the dissected cadavers directly without burial, with the help of technicians by using common instruments in the dissection hall like scalpels, scissors, and forceps to leave the bones with minimal soft tissue attachments. Then these bones were put in different solutions like H2O2, NaOH, Limewater and Plain water with sun exposure in daytime for a week. Finally the bones were then washed in running water and air dried under the fan. Results: The best method found suitable for the clean and white bone preparation in this study was using the chemical Limewater. The smell of the bones prepared and the process is not as strong/difficult and distasteful as perceived in the other methods like burial, leaving open above ground, boiling, using enzymes and bugs etc. Discussion: Most of the methods of bone preparation are tedious and time consuming. Also, they need training and expertise of persons doing these procedures. In present study we found that using Limewater (a clear liquid consisting of calcium hydroxide) with sunlight exposure in daytime for a week time, was the best method in the terms of less time required, the odourless and white colour and bones prepared and the simplicity of the process. So we are now able to find out the most suitable organic method by which bones can be prepared with least damage and for a good presentable appearance.

Keywords: Maceration; Chemical preparation; Burial; Osteology; Cleaning.

Background: Estimation of stature plays an outstanding role in personal identification. It has a significant importance in forensic anthropometry. Objective: The present study is an attempt to evaluate a possible correlation between stature of an individual and hand length and hand breadth in tribal population of Udaipur. Materials and Methods: The present study was conducted on 200 tribal males and 200 tribal females in age group of 18–32 years. All the measurements were done by using standard anthropometric instruments and standard anthropometric techniques. Results: There was a positive but low correlation between height and various hand parameters with with increase in height there is increase in the hand parameters but with less relationship for statistical analysis SPSS (Version 17) was used. Conclusion: The present study has provided regression equations for various hand parameters hand length and hand breadth.

Keywords: Stature; Hand length; Hand breadth; Regression equation.

Introduction: Knowledge of size and shape of proximal end of radius i.e. radial head is necessary for creation of anatomically and biomechanically correct radial head prosthesis. This difference in biome-chanics of circular shape and the elliptical shape of radial head must be taken in consideration in design of radial head prosthesis.2 Further understanding of dimensions of bicipital tuberosity and its angular relationship to radial head is important in pathophysiology of bicepstendon rup-ture as well as to facilitate surgical procedures like reconstruction of biceps tendon, radial head prosthesis and implantation and reconstruction of proximal head trauma.3 Several studies have been published on anatomy using different technical approaches however, most of these studies were conducted with special focus on parameters relevant to radi-al prosthetic design. The purpose of this study was to explore the complex geometry of the prox-imal radius with regard to fracture implant design.4 Methods: Randomly selected 100 right and 100 left dried radii of Adult Human (20 years and above) of unknown gender were studied. The data obtained was analyzed statistically to find out mean, range, SD, standard error and 95% confidence intervals of observations. Box and whisker’s plot are showing the pictorial forms of the observation sat a glance. Results: The mean height, anteroposterior and transverse diameter of head, length of radial neck, length of radial tuberosity, Neck shaft angle of radius, circumference at radial tuberosity of radius were 10.39 mm, 20.21 mm, 19.65 mm 11.62 mm, 19.40 mm, 169.29 degree and 4.78 cm respectively.

Keywords: Radial Head; Neck; Angle; Prosthesis.