Dibakar Borthakur - Srimanta Sankaradeva University Of Health Sciences (original) (raw)
Papers by Dibakar Borthakur
Is it time for anatomists to enter the OT? Their role in clinical anatomy education of residents: A pre-trial survey research among surgeons
Bratislavské lekárske listy/Bratislava medical journal, May 21, 2024
Prague Medical Report, 2024
Anatomical variations of the forearm flexor muscles are occasionally encountered. Though usually ... more Anatomical variations of the forearm flexor muscles are occasionally encountered. Though usually observed incidentally during autopsies or imaging studies, they may at times cause concern due to associated clinical symptoms. This report presents a case of unilateral accessory flexor carpi ulnaris (AFCU) muscle observed in a human male cadaver aged 78 years. During routine cadaveric dissection, an anomalous AFCU muscle was observed in the left forearm of a human male cadaver aged 78 years. Standard institutional guidelines pertaining to the use of human cadaver for teaching and research were followed. A thorough literature review about the flexor carpi ulnaris (FCU) through the PubMed, Embase and Google scholar databases was undertaken, using the keywords -accessory flexor carpi ulnaris muscle, aberrant flexor carpi ulnaris muscle and anatomical variation of flexor carpi ulnaris muscle. Relevant gross anatomical findings were recorded and photographed. AFCU was identified on the medial aspect of the distal third of the left forearm. The AFCU was found originating from the ante-brachial fascia and the fascia covering the FCU on the left forearm, forming a small separate belly deep to the main muscle. It terminated as a thin tendon running alongside the hypothenar muscles and attached distally to the base of the proximal phalanx of the little finger. The AFCU was found to be innervated by a branch of the ulnar nerve. Awareness about the rare AFCU muscle is clinically important as a possible cause of ulnar nerve compression but also as a possible graft in reconstruction surgeries.
Jornal Vascular Brasileiro, 2024
Knowledge of the anatomical variations of the visceral branches of the abdominal aorta is importa... more Knowledge of the anatomical variations of the visceral branches of the abdominal aorta is important information for planning any surgeries in the region. We present here a rare constellation of variations of visceral vessels around the kidneys with a brief review of the recent literature. On the right side, an accessory renal artery was observed originating just distal to the main renal artery. The middle suprarenal artery was absent on the right side and there were two inferior suprarenal arteries originating from a branch of the main right renal artery. On the left side, the testicular artery had an arched course anterior to the left renal vein mimicking an unusual variety of nutcracker phenomenon. The right kidney was drained by two renal veins into the inferior vena cava. Knowledge of the coexistence of such complex anatomical variations might be helpful for clinicians during diagnostic and therapeutic procedures.
Medeniyet medical journal, Jan 3, 2024
Clinical Relevance of Sternal Foramina: A Morphometric Study
PubMed, Dec 3, 2023
Objectives: The present study aimed at determining the incidence of sternal foramina in adult dry... more Objectives: The present study aimed at determining the incidence of sternal foramina in adult dry bones of North Indian descent. We also aimed to determine the number, precise location of the sternal foramina with a standard reference point which might have considerable importance with regard to procedures involving sternal puncture. Methods: This cross sectional descriptive study was conducted on 72 dry adult human sternums. Various measurements in relation to the sternal foramina were taken with a non-stretchable measuring tape and digital vernier calliper and expressed as: [A]-total sternal length, [B]-distance between the jugular notches to the foramen, [C]-distance between the angle of Louis to the foramen and [D]-distance of the foramen from the mid sternal plane. Statistical analysis was performed with Microsoft Excel version 2019. A p-value of <0.05 was considered significant. Results: We found 6.94% (5 out of 72 sternums) incidence of sternal foramina which corroborates well with the existing literature. Mean sternal length was 127.7 ± 09 mm. The mean distance of the foramina from suprasternal notch, sternal angle and from the median plane were 118.12 ± 0.3 mm, 116.7 mm and 2.4 mm respectively. Incidence of sternal foramina was almost similar to previously reported studies. Conclusions: The precise knowledge about the expected location of sternal foramina is imperative to avoid intra-thoracic visceral injury during commonly performed acupuncture needle insertion and while doing bone marrow aspiration for diagnostic evaluation.
Acta medica Lituanica, Feb 28, 2024
Nutcracker phenomenon (NCP) typically refers to the entrapment of the left renal vein (LRV) betwe... more Nutcracker phenomenon (NCP) typically refers to the entrapment of the left renal vein (LRV) between the aorta and the superior mesenteric artery. Similar to the classic NCP, the renal vein can also get entrapped between the segmental branches of the renal artery at the renal hilum, which has been referred to as 'renal hilar nutcracker phenomenon (RHNP). ' During routine dissection of a male cadaver of 67 years, the renal veins of both sides at the renal hilum were seen between the segmental branches of renal arteries, which we identified as the 'renal hilar nutcracker phenomenon. ' The disposition of the rest of the perihilar structures was normal. 'Renal hilar nutcracker phenomenon' can have similar clinical presentation like that of the nutcracker phenomenon. Hence, knowledge of such anatomical variation at the renal hilum is desirable.
Folia Morphologica
We read the article "A left circumflex aorta with a displaced thoracic duct in a 94-year-old male... more We read the article "A left circumflex aorta with a displaced thoracic duct in a 94-year-old male cadaver: a case report with discussion on embryology" by Ostrowski et. al. with great
Characteristics of Pediatric Scrub Typhus during an Outbreak in the North Eastern Region of India: Peculiarities in Clinical Presentation, Laboratory Findings and Complications
The Indian Journal of Pediatrics, 2011
To identify and report a recent outbreak of scrub typhus cases recorded from October 2009 to Janu... more To identify and report a recent outbreak of scrub typhus cases recorded from October 2009 to January 2010 in the state of Meghalaya, India. The case sheets of all the children were retrieved and reviewed retrospectively. Twenty four (24) patients, who were both clinically and serologically confirmed as scrub typhus cases were included in the study. Fever for more than 1 wk duration was the most common manifestation (100%) followed by splenomegaly (45.8%), eschar (41.7%), cough (37.5%), hepatomegaly (33.3%), headache and body ache (25%), pain abdomen (25%), vomiting (20.8%), altered sensorium (16.6%), seizures (12.5%) lymphadenopathy (12.5%), and loose stools (8.3%). Meningoencephalitis was the most common complication (29.2%) followed by pneumonia (16.3%) and subconjunctival hemorrhage (8.3%).Cortical blindness, septic shock, peritonitis, myocarditis with CCF, pancytopenia, acute renal failure, coagulopathy, prolonged oxygen dependency and urinary tract infection (UTI) were found in one of each case. Hyponatremia (66.7%), elevated liver enzymes without significant rise of bilirubin (58.3%), hypoalbuminemia (52.2%) and thrombocytopenia (26%) were the other significant laboratory findings. Patients were treated with chloramphenicol, doxycycline and azithromycin. There was no mortality. This is the first outbreak report from the north eastern region of India with varied clinical presentations, laboratory investigations and complications. Weil Felix test still remains fruitful for diagnosing this disease in a resource limited set up.
The Indian Journal of Pediatrics, 2012
Objectives To report an outbreak of invasive meningococcal disease from Meghalaya, in the north e... more Objectives To report an outbreak of invasive meningococcal disease from Meghalaya, in the north east India, from January 2008 through June 2009. Methods Retrospective review of case sheets was done. One hundred ten patients with invasive meningococcal disease were included for the study. Results Of the total patients, 61.8 % were boys and 38.2 % were girls (boy to girl ratio01.62:1). The average age of presentation was 8.48 ± 5.09 y. Meningococcal meningitis was seen in 61.8 % of cases, meningococcemia in 20 % and 18.2 % had both. Fever was the most common manifestation (100 %) followed by meningeal signs (78.2 %), headache (56.4 %), vomiting (53.6 %), shock (38.2 %), low Glasgow coma scale (GCS) (25.5 %), purpura and rashes (23.6 %), seizures (9.1 %), abdominal symptoms (4.5 %), irritability and excessive crying (4.5 %) and bulging anterior fontanalle (23 %) in those below 18 mo of age. Raised intracranial pressure (ICP) was the most common complication (28.2 %) followed by coagulopathy (16.4 %), hepatopathy (10 %), herpes labialis (9.1 %), syndrome of inappropriate ADH secretion (SIADH) (8 %), pneumonia (7 %), arthritis (6 %), purpura fulminans, respiratory failure, sixth nerve palsy and diabetes insipidus in 4.5 % each, subdural empyema, optic neuritis, ARDS and ARF in 1.8 % each, cerebral salt wasting syndrome, third nerve palsy, cerebritis and hearing impairment in 0.9 % each. Culture was positive in 35.5 %. Patients were treated initially with ceftriaxone and dexamethasone but later on with chloramphenicol due to clinical drug resistance. Mortality was 6.4 %. Conclusions This is the first epidemic report of invasive meningococcal disease from the north east India. Chloramphenicol acts well in areas with penicillin or cephalosporin resistance. Mortality reduces significantly with early diagnosis and prompt intervention.
Histomorphology of Von Economo Neurons in the Limbic Cortex of Cadaveric Brains
IBRO Neuroscience Reports
Morphometric Parameters of the Cavity and Floor of the Third Ventricle in Indian Population: Clinical Implications
IBRO Neuroscience Reports
Fetal Type of Posterior Cerebral Artery in Indian Population- a Cadaveric Study with Clinical and Embryological Implications
IBRO Neuroscience Reports
Medeniyet medical journal, Mar 27, 2023
Objective: The introduction of competency-based medical education curriculum and a shifted focus ... more Objective: The introduction of competency-based medical education curriculum and a shifted focus towards self-directed learning (SDL) in medical schools across the world has necessitated a reduction of didactic teaching hours. Museum specimens are an indispensable tool in anatomy teaching and can play a pivotal role in fostering and reinforcing SDL. Coloring of specimens makes it attractive and facilitates understanding anatomy. The aims of this study were: (1) weigh up the two commonly used coloring materials in anatomy viz. acrylic paint and nail polish; and (2) to assess the perception of anatomy students towards a Novel Osteo Refurbishment Method (NORM) for restoration of partially damaged osteology specimens. Methods: Undergraduate and postgraduate students of anatomy were recruited in the study. Participants responded to a 5-point Likert scale questionnaire. Obtained data were analyzed using Microsoft Excel version 2019. For a comparison of the two coloring agents Mann-Whitney U test was applied to the responses toward the Likert scale-based questionnaire. P-value <0.05 was considered significant. Results: Out of 318 study participants, 63.7% and 36.3% of the respondents were male and female, respectively. 90.5 % were new entrants to university and the remainder 9.5% had a prior university degree. Students found the acrylic paint to be a better coloring agent and they also opined that NORM generated refurbished osteology specimens could serve as a useful selflearning tool. Acrylic paint was found to be more suitable as compared to nail polish with significant p-value in most of the parameters tested. Conclusions: Acrylic colour holds a good place in coloring both specimens and models in anatomy. Nail polish can be an alternative but with some noted disadvantages. The initial experience with NORM yielded encouraging results with potential practical utility.
Bilateral Bifid Tendon of Palmaris Longus - Advantageous in Tendon Transfer?
PubMed, Jun 28, 2023
Background: Variable insertions of Palmaris longus (PL) muscle tendon is described by various aut... more Background: Variable insertions of Palmaris longus (PL) muscle tendon is described by various authors. Presence of extra PL tendon is also described in literature. As autologus tendon grafting is a blooming arena of clinical research at present time, an additional tendinous slip of PL has promising scope for use as an autograft. Case report: We report here bilateral bitendinous distal attachment of PL muscle encountered during routine cadaveric dissection. The additional PL tendon in a multitendinous insertion pattern with optimum length and thickness is indeed an additional advantage from the point of view of autograft harvesting. This has also importance in understanding the unusual, altered symptomatology in compressive conditions. Conclusion: Although relatively common, surgeons should be well aware of the various possible aversion of distal attachment of PL which might have significant impact in alteration of symptomatology of neurovascular compressions in the forearm and hand and while choosing an appropriate tendon autograft.
Complete Ossification of Transverse Acetabular Ligament - Embryological and Clinical Perspective
PubMed, Jun 28, 2023
Transverse acetabular ligament (TAL) is one of the important ligaments, which provide stability t... more Transverse acetabular ligament (TAL) is one of the important ligaments, which provide stability to the hip joint. On rare occasions, it can get ossified leading to limited mobility of the hip joint. Ossified TAL also converts acetabular notch to a foramen and neurovascular structures passing through the notch can get compressed leading to ischaemic symptoms. During routine demonstration of hip bone to undergraduate students, complete ossification of TAL was found in a right sided hip bone. Present case report with this rare finding also includes a short review of literature impressing on embryological and clinical perspectives of ossified TAL. Ossification of this ligament can be caused by defective ossification of hip bone as three secondary ossification centres develop around the acetabulum in triradiate carti-lage. Also, this can be caused due to heterotopic ossification of TAL after an inflammatory or traumatic injury. This ligament is extremely important in total hip replacement surgery being utilised in determining the position of the acetabular component. Anatomical knowledge of abnormal ossification of TAL is imperative in diagnosis and treatment of various pathologies of the hip joint.
Anatomical diversity of inferior belly of the omohyoid muscle – Anatomical, physiological and surgical paradigm
Morphologie, Mar 1, 2023
Omohyoid muscle is one of the infrahyoid muscles of the neck which consists of two bellies combin... more Omohyoid muscle is one of the infrahyoid muscles of the neck which consists of two bellies combined at an angle by an intermediate tendon. The inferior belly is a flat, narrow band, which inclines forwards and upwards in the lower part of the neck. It generally originates from the upper border of the scapula, medial to scapular notch. The present case showed unilateral anomalous attachment of the inferior belly of the omohyoid on the medial part of clavicle on left side. Inferior belly was 2.2cm lateral to left sternoclavicular joint with 3.2 and 1.5cm in length and breadth, innervated by ansa cervicalis. Only 3% of this type of variation has been observed until now according to previous literature. Anterior and posterior triangles of neck on both sides of the cadaver were dissected during routine dissection for undergraduate teaching. There was no scapular attachment of inferior belly of the omohyoid on the left side. It was directly originating from the upper surface of the medial side of the left clavicle. Variation in the attachment of inferior belly can have a direct impact on the internal jugular vein and brachial plexus during neck surgeries or trauma due to its close relation to the mentioned structures. This variation should also be taken care during infrahyoid myocutaneus flap extraction for reconstruction surgery of tongue in cases of lingual carcinoma.
Medeniyet Medical Journal
We would like to thank Ekrem Solmaz and his colleagues for their interest in our publication and ... more We would like to thank Ekrem Solmaz and his colleagues for their interest in our publication and are pleased to have the opportunity to correct mistakes that unfortunately occurred during the tabulation of different studies. With reference to Table no. 1 of our study, we would like to correct the description of methodology and findings of the study done by Solmaz et al. 1 , mentioned in Table 1, which highlighted incidences of incomplete type of superficial palmar arch (SPA) 2. They studied the type of SPA and their variations in 80 upper extremities of formalin-fixed human fetuses. The most frequent type of SPA encountered was the complete type (72.5%). Type A (47.5%) was the most common type in the complete group, and type A (15%) was also observed to be the most common type in the incomplete group 1 .
An Atypical Case of Meckel's Diverticulum with Small Bowel Obstruction: Surgical Anatomy, Embryology and Clinical Implications
Clinica Terapeutica, Mar 16, 2023
Origin of triple right coronary with separate ostium
Morphologie
Medeniyet Medical Journal
Objective: The introduction of competency-based medical education curriculum and a shifted focus ... more Objective: The introduction of competency-based medical education curriculum and a shifted focus towards self-directed learning (SDL) in medical schools across the world has necessitated a reduction of didactic teaching hours. Museum specimens are an indispensable tool in anatomy teaching and can play a pivotal role in fostering and reinforcing SDL. Coloring of specimens makes it attractive and facilitates understanding anatomy. The aims of this study were: (1) weigh up the two commonly used coloring materials in anatomy viz. acrylic paint and nail polish; and (2) to assess the perception of anatomy students towards a Novel Osteo Refurbishment Method (NORM) for restoration of partially damaged osteology specimens. Methods: Undergraduate and postgraduate students of anatomy were recruited in the study. Participants responded to a 5-point Likert scale questionnaire. Obtained data were analyzed using Microsoft Excel version 2019. For a comparison of the two coloring agents Mann-Whitney U test was applied to the responses toward the Likert scale-based questionnaire. P-value <0.05 was considered significant. Results: Out of 318 study participants, 63.7% and 36.3% of the respondents were male and female, respectively. 90.5 % were new entrants to university and the remainder 9.5% had a prior university degree. Students found the acrylic paint to be a better coloring agent and they also opined that NORM generated refurbished osteology specimens could serve as a useful selflearning tool. Acrylic paint was found to be more suitable as compared to nail polish with significant p-value in most of the parameters tested. Conclusions: Acrylic colour holds a good place in coloring both specimens and models in anatomy. Nail polish can be an alternative but with some noted disadvantages. The initial experience with NORM yielded encouraging results with potential practical utility.
Is it time for anatomists to enter the OT? Their role in clinical anatomy education of residents: A pre-trial survey research among surgeons
Bratislavské lekárske listy/Bratislava medical journal, May 21, 2024
Prague Medical Report, 2024
Anatomical variations of the forearm flexor muscles are occasionally encountered. Though usually ... more Anatomical variations of the forearm flexor muscles are occasionally encountered. Though usually observed incidentally during autopsies or imaging studies, they may at times cause concern due to associated clinical symptoms. This report presents a case of unilateral accessory flexor carpi ulnaris (AFCU) muscle observed in a human male cadaver aged 78 years. During routine cadaveric dissection, an anomalous AFCU muscle was observed in the left forearm of a human male cadaver aged 78 years. Standard institutional guidelines pertaining to the use of human cadaver for teaching and research were followed. A thorough literature review about the flexor carpi ulnaris (FCU) through the PubMed, Embase and Google scholar databases was undertaken, using the keywords -accessory flexor carpi ulnaris muscle, aberrant flexor carpi ulnaris muscle and anatomical variation of flexor carpi ulnaris muscle. Relevant gross anatomical findings were recorded and photographed. AFCU was identified on the medial aspect of the distal third of the left forearm. The AFCU was found originating from the ante-brachial fascia and the fascia covering the FCU on the left forearm, forming a small separate belly deep to the main muscle. It terminated as a thin tendon running alongside the hypothenar muscles and attached distally to the base of the proximal phalanx of the little finger. The AFCU was found to be innervated by a branch of the ulnar nerve. Awareness about the rare AFCU muscle is clinically important as a possible cause of ulnar nerve compression but also as a possible graft in reconstruction surgeries.
Jornal Vascular Brasileiro, 2024
Knowledge of the anatomical variations of the visceral branches of the abdominal aorta is importa... more Knowledge of the anatomical variations of the visceral branches of the abdominal aorta is important information for planning any surgeries in the region. We present here a rare constellation of variations of visceral vessels around the kidneys with a brief review of the recent literature. On the right side, an accessory renal artery was observed originating just distal to the main renal artery. The middle suprarenal artery was absent on the right side and there were two inferior suprarenal arteries originating from a branch of the main right renal artery. On the left side, the testicular artery had an arched course anterior to the left renal vein mimicking an unusual variety of nutcracker phenomenon. The right kidney was drained by two renal veins into the inferior vena cava. Knowledge of the coexistence of such complex anatomical variations might be helpful for clinicians during diagnostic and therapeutic procedures.
Medeniyet medical journal, Jan 3, 2024
Clinical Relevance of Sternal Foramina: A Morphometric Study
PubMed, Dec 3, 2023
Objectives: The present study aimed at determining the incidence of sternal foramina in adult dry... more Objectives: The present study aimed at determining the incidence of sternal foramina in adult dry bones of North Indian descent. We also aimed to determine the number, precise location of the sternal foramina with a standard reference point which might have considerable importance with regard to procedures involving sternal puncture. Methods: This cross sectional descriptive study was conducted on 72 dry adult human sternums. Various measurements in relation to the sternal foramina were taken with a non-stretchable measuring tape and digital vernier calliper and expressed as: [A]-total sternal length, [B]-distance between the jugular notches to the foramen, [C]-distance between the angle of Louis to the foramen and [D]-distance of the foramen from the mid sternal plane. Statistical analysis was performed with Microsoft Excel version 2019. A p-value of <0.05 was considered significant. Results: We found 6.94% (5 out of 72 sternums) incidence of sternal foramina which corroborates well with the existing literature. Mean sternal length was 127.7 ± 09 mm. The mean distance of the foramina from suprasternal notch, sternal angle and from the median plane were 118.12 ± 0.3 mm, 116.7 mm and 2.4 mm respectively. Incidence of sternal foramina was almost similar to previously reported studies. Conclusions: The precise knowledge about the expected location of sternal foramina is imperative to avoid intra-thoracic visceral injury during commonly performed acupuncture needle insertion and while doing bone marrow aspiration for diagnostic evaluation.
Acta medica Lituanica, Feb 28, 2024
Nutcracker phenomenon (NCP) typically refers to the entrapment of the left renal vein (LRV) betwe... more Nutcracker phenomenon (NCP) typically refers to the entrapment of the left renal vein (LRV) between the aorta and the superior mesenteric artery. Similar to the classic NCP, the renal vein can also get entrapped between the segmental branches of the renal artery at the renal hilum, which has been referred to as 'renal hilar nutcracker phenomenon (RHNP). ' During routine dissection of a male cadaver of 67 years, the renal veins of both sides at the renal hilum were seen between the segmental branches of renal arteries, which we identified as the 'renal hilar nutcracker phenomenon. ' The disposition of the rest of the perihilar structures was normal. 'Renal hilar nutcracker phenomenon' can have similar clinical presentation like that of the nutcracker phenomenon. Hence, knowledge of such anatomical variation at the renal hilum is desirable.
Folia Morphologica
We read the article "A left circumflex aorta with a displaced thoracic duct in a 94-year-old male... more We read the article "A left circumflex aorta with a displaced thoracic duct in a 94-year-old male cadaver: a case report with discussion on embryology" by Ostrowski et. al. with great
Characteristics of Pediatric Scrub Typhus during an Outbreak in the North Eastern Region of India: Peculiarities in Clinical Presentation, Laboratory Findings and Complications
The Indian Journal of Pediatrics, 2011
To identify and report a recent outbreak of scrub typhus cases recorded from October 2009 to Janu... more To identify and report a recent outbreak of scrub typhus cases recorded from October 2009 to January 2010 in the state of Meghalaya, India. The case sheets of all the children were retrieved and reviewed retrospectively. Twenty four (24) patients, who were both clinically and serologically confirmed as scrub typhus cases were included in the study. Fever for more than 1 wk duration was the most common manifestation (100%) followed by splenomegaly (45.8%), eschar (41.7%), cough (37.5%), hepatomegaly (33.3%), headache and body ache (25%), pain abdomen (25%), vomiting (20.8%), altered sensorium (16.6%), seizures (12.5%) lymphadenopathy (12.5%), and loose stools (8.3%). Meningoencephalitis was the most common complication (29.2%) followed by pneumonia (16.3%) and subconjunctival hemorrhage (8.3%).Cortical blindness, septic shock, peritonitis, myocarditis with CCF, pancytopenia, acute renal failure, coagulopathy, prolonged oxygen dependency and urinary tract infection (UTI) were found in one of each case. Hyponatremia (66.7%), elevated liver enzymes without significant rise of bilirubin (58.3%), hypoalbuminemia (52.2%) and thrombocytopenia (26%) were the other significant laboratory findings. Patients were treated with chloramphenicol, doxycycline and azithromycin. There was no mortality. This is the first outbreak report from the north eastern region of India with varied clinical presentations, laboratory investigations and complications. Weil Felix test still remains fruitful for diagnosing this disease in a resource limited set up.
The Indian Journal of Pediatrics, 2012
Objectives To report an outbreak of invasive meningococcal disease from Meghalaya, in the north e... more Objectives To report an outbreak of invasive meningococcal disease from Meghalaya, in the north east India, from January 2008 through June 2009. Methods Retrospective review of case sheets was done. One hundred ten patients with invasive meningococcal disease were included for the study. Results Of the total patients, 61.8 % were boys and 38.2 % were girls (boy to girl ratio01.62:1). The average age of presentation was 8.48 ± 5.09 y. Meningococcal meningitis was seen in 61.8 % of cases, meningococcemia in 20 % and 18.2 % had both. Fever was the most common manifestation (100 %) followed by meningeal signs (78.2 %), headache (56.4 %), vomiting (53.6 %), shock (38.2 %), low Glasgow coma scale (GCS) (25.5 %), purpura and rashes (23.6 %), seizures (9.1 %), abdominal symptoms (4.5 %), irritability and excessive crying (4.5 %) and bulging anterior fontanalle (23 %) in those below 18 mo of age. Raised intracranial pressure (ICP) was the most common complication (28.2 %) followed by coagulopathy (16.4 %), hepatopathy (10 %), herpes labialis (9.1 %), syndrome of inappropriate ADH secretion (SIADH) (8 %), pneumonia (7 %), arthritis (6 %), purpura fulminans, respiratory failure, sixth nerve palsy and diabetes insipidus in 4.5 % each, subdural empyema, optic neuritis, ARDS and ARF in 1.8 % each, cerebral salt wasting syndrome, third nerve palsy, cerebritis and hearing impairment in 0.9 % each. Culture was positive in 35.5 %. Patients were treated initially with ceftriaxone and dexamethasone but later on with chloramphenicol due to clinical drug resistance. Mortality was 6.4 %. Conclusions This is the first epidemic report of invasive meningococcal disease from the north east India. Chloramphenicol acts well in areas with penicillin or cephalosporin resistance. Mortality reduces significantly with early diagnosis and prompt intervention.
Histomorphology of Von Economo Neurons in the Limbic Cortex of Cadaveric Brains
IBRO Neuroscience Reports
Morphometric Parameters of the Cavity and Floor of the Third Ventricle in Indian Population: Clinical Implications
IBRO Neuroscience Reports
Fetal Type of Posterior Cerebral Artery in Indian Population- a Cadaveric Study with Clinical and Embryological Implications
IBRO Neuroscience Reports
Medeniyet medical journal, Mar 27, 2023
Objective: The introduction of competency-based medical education curriculum and a shifted focus ... more Objective: The introduction of competency-based medical education curriculum and a shifted focus towards self-directed learning (SDL) in medical schools across the world has necessitated a reduction of didactic teaching hours. Museum specimens are an indispensable tool in anatomy teaching and can play a pivotal role in fostering and reinforcing SDL. Coloring of specimens makes it attractive and facilitates understanding anatomy. The aims of this study were: (1) weigh up the two commonly used coloring materials in anatomy viz. acrylic paint and nail polish; and (2) to assess the perception of anatomy students towards a Novel Osteo Refurbishment Method (NORM) for restoration of partially damaged osteology specimens. Methods: Undergraduate and postgraduate students of anatomy were recruited in the study. Participants responded to a 5-point Likert scale questionnaire. Obtained data were analyzed using Microsoft Excel version 2019. For a comparison of the two coloring agents Mann-Whitney U test was applied to the responses toward the Likert scale-based questionnaire. P-value <0.05 was considered significant. Results: Out of 318 study participants, 63.7% and 36.3% of the respondents were male and female, respectively. 90.5 % were new entrants to university and the remainder 9.5% had a prior university degree. Students found the acrylic paint to be a better coloring agent and they also opined that NORM generated refurbished osteology specimens could serve as a useful selflearning tool. Acrylic paint was found to be more suitable as compared to nail polish with significant p-value in most of the parameters tested. Conclusions: Acrylic colour holds a good place in coloring both specimens and models in anatomy. Nail polish can be an alternative but with some noted disadvantages. The initial experience with NORM yielded encouraging results with potential practical utility.
Bilateral Bifid Tendon of Palmaris Longus - Advantageous in Tendon Transfer?
PubMed, Jun 28, 2023
Background: Variable insertions of Palmaris longus (PL) muscle tendon is described by various aut... more Background: Variable insertions of Palmaris longus (PL) muscle tendon is described by various authors. Presence of extra PL tendon is also described in literature. As autologus tendon grafting is a blooming arena of clinical research at present time, an additional tendinous slip of PL has promising scope for use as an autograft. Case report: We report here bilateral bitendinous distal attachment of PL muscle encountered during routine cadaveric dissection. The additional PL tendon in a multitendinous insertion pattern with optimum length and thickness is indeed an additional advantage from the point of view of autograft harvesting. This has also importance in understanding the unusual, altered symptomatology in compressive conditions. Conclusion: Although relatively common, surgeons should be well aware of the various possible aversion of distal attachment of PL which might have significant impact in alteration of symptomatology of neurovascular compressions in the forearm and hand and while choosing an appropriate tendon autograft.
Complete Ossification of Transverse Acetabular Ligament - Embryological and Clinical Perspective
PubMed, Jun 28, 2023
Transverse acetabular ligament (TAL) is one of the important ligaments, which provide stability t... more Transverse acetabular ligament (TAL) is one of the important ligaments, which provide stability to the hip joint. On rare occasions, it can get ossified leading to limited mobility of the hip joint. Ossified TAL also converts acetabular notch to a foramen and neurovascular structures passing through the notch can get compressed leading to ischaemic symptoms. During routine demonstration of hip bone to undergraduate students, complete ossification of TAL was found in a right sided hip bone. Present case report with this rare finding also includes a short review of literature impressing on embryological and clinical perspectives of ossified TAL. Ossification of this ligament can be caused by defective ossification of hip bone as three secondary ossification centres develop around the acetabulum in triradiate carti-lage. Also, this can be caused due to heterotopic ossification of TAL after an inflammatory or traumatic injury. This ligament is extremely important in total hip replacement surgery being utilised in determining the position of the acetabular component. Anatomical knowledge of abnormal ossification of TAL is imperative in diagnosis and treatment of various pathologies of the hip joint.
Anatomical diversity of inferior belly of the omohyoid muscle – Anatomical, physiological and surgical paradigm
Morphologie, Mar 1, 2023
Omohyoid muscle is one of the infrahyoid muscles of the neck which consists of two bellies combin... more Omohyoid muscle is one of the infrahyoid muscles of the neck which consists of two bellies combined at an angle by an intermediate tendon. The inferior belly is a flat, narrow band, which inclines forwards and upwards in the lower part of the neck. It generally originates from the upper border of the scapula, medial to scapular notch. The present case showed unilateral anomalous attachment of the inferior belly of the omohyoid on the medial part of clavicle on left side. Inferior belly was 2.2cm lateral to left sternoclavicular joint with 3.2 and 1.5cm in length and breadth, innervated by ansa cervicalis. Only 3% of this type of variation has been observed until now according to previous literature. Anterior and posterior triangles of neck on both sides of the cadaver were dissected during routine dissection for undergraduate teaching. There was no scapular attachment of inferior belly of the omohyoid on the left side. It was directly originating from the upper surface of the medial side of the left clavicle. Variation in the attachment of inferior belly can have a direct impact on the internal jugular vein and brachial plexus during neck surgeries or trauma due to its close relation to the mentioned structures. This variation should also be taken care during infrahyoid myocutaneus flap extraction for reconstruction surgery of tongue in cases of lingual carcinoma.
Medeniyet Medical Journal
We would like to thank Ekrem Solmaz and his colleagues for their interest in our publication and ... more We would like to thank Ekrem Solmaz and his colleagues for their interest in our publication and are pleased to have the opportunity to correct mistakes that unfortunately occurred during the tabulation of different studies. With reference to Table no. 1 of our study, we would like to correct the description of methodology and findings of the study done by Solmaz et al. 1 , mentioned in Table 1, which highlighted incidences of incomplete type of superficial palmar arch (SPA) 2. They studied the type of SPA and their variations in 80 upper extremities of formalin-fixed human fetuses. The most frequent type of SPA encountered was the complete type (72.5%). Type A (47.5%) was the most common type in the complete group, and type A (15%) was also observed to be the most common type in the incomplete group 1 .
An Atypical Case of Meckel's Diverticulum with Small Bowel Obstruction: Surgical Anatomy, Embryology and Clinical Implications
Clinica Terapeutica, Mar 16, 2023
Origin of triple right coronary with separate ostium
Morphologie
Medeniyet Medical Journal
Objective: The introduction of competency-based medical education curriculum and a shifted focus ... more Objective: The introduction of competency-based medical education curriculum and a shifted focus towards self-directed learning (SDL) in medical schools across the world has necessitated a reduction of didactic teaching hours. Museum specimens are an indispensable tool in anatomy teaching and can play a pivotal role in fostering and reinforcing SDL. Coloring of specimens makes it attractive and facilitates understanding anatomy. The aims of this study were: (1) weigh up the two commonly used coloring materials in anatomy viz. acrylic paint and nail polish; and (2) to assess the perception of anatomy students towards a Novel Osteo Refurbishment Method (NORM) for restoration of partially damaged osteology specimens. Methods: Undergraduate and postgraduate students of anatomy were recruited in the study. Participants responded to a 5-point Likert scale questionnaire. Obtained data were analyzed using Microsoft Excel version 2019. For a comparison of the two coloring agents Mann-Whitney U test was applied to the responses toward the Likert scale-based questionnaire. P-value <0.05 was considered significant. Results: Out of 318 study participants, 63.7% and 36.3% of the respondents were male and female, respectively. 90.5 % were new entrants to university and the remainder 9.5% had a prior university degree. Students found the acrylic paint to be a better coloring agent and they also opined that NORM generated refurbished osteology specimens could serve as a useful selflearning tool. Acrylic paint was found to be more suitable as compared to nail polish with significant p-value in most of the parameters tested. Conclusions: Acrylic colour holds a good place in coloring both specimens and models in anatomy. Nail polish can be an alternative but with some noted disadvantages. The initial experience with NORM yielded encouraging results with potential practical utility.