CONTEMPORARY UNDERSTANDING OF SHADCHAKRA: A SYSTEMATIC REVIEW

Contemporary science is a bridge between Ayurveda and modern science that enlightened the old concepts and familiar to the scientific community. It has been broadly accepted in the scientific community that the physiological functions of the body is influenced by Shatchakra. The literature review of this article explain that Intercellular gap junction or nexuses regulate physiological mechanism underlying subtle energy systems. Furthermore, electrical conduction associated with gap junctions could generate phenomena which, have the radiant qualities attributed to Chakra. This study aims to critically analyze and explore the concept of Shadchakras anatomy with its radiological evidence to prove and understand its therapeutic potential in light of contemporary science language. For this review, we had collected information from Ayurveda and modern literature on the subject of Shadchakras. Scientific pieces of evidence provide prove about Shadchakras existence with anatomical correlation and physiologically as a part of Sukshma Sharir which can affect our body and mind as well and maintain quality of life.

Three Dimensional Brain Reconstruction Optimizes Surgical Approaches and Medical Education in Minimally Invasive Neurosurgery for Refractory Epilepsy

Epilepsy is a prevalent condition that affects 1–3% of the population or about 50–65 million people worldwide (WHO estimates) and about 3.5 million people in the USA alone (CDC estimates). Refractory epilepsy refers to patients that respond inadequately to medical management alone (at least two anti-seizure medications at appropriate doses) and are appropriate candidates for other interventions such as brain surgery or the use of neurostimulators for their epilepsy. Minimally invasive techniques like stereotactic EEG electrodes offer excellent investigational abilities to study the diagnostic attributes of the seizure networks, while therapies like laser ablations and neurostimulators permit intervention and modulation of these networks to offer seizure control with minimal cognitive compromise and surgical morbidity. The accuracy of these techniques is highly contingent on precise anatomical correlation between the location of the electrodes and their proximity to relevant structures of the brain. Ensuring good anatomical correlation using 3-dimensional (3D) reconstructions would permit precise localization and accurate understanding of the seizure networks. Accurate localization of stereotactic electrodes would enable precise understanding of the electrical networks and identify vital nodes in the seizure network. These reconstructions would also permit better understanding of the proximity of these electrodes to each other and help confirm arrangement of neurostimulators to maximize modulatory effects on the networks. Such reconstructions would enable better understanding of neuroanatomy and connectivity to improve knowledge of brain structures and relations in neurological conditions. These methods would enable medical students and doctors-in-training to better their understanding of neurological disease and the necessary interventions.

Anatomical study between the correlation of the arcuate eminence and the superior semicircular canal

Objective To study the anatomical correlation between the arcuate eminence and the superior semicircular canal. Material and methods A study of the height of the arcuate eminence was carried out in 295 temporal bones. In addition, 30 temporals with different heights of the arcuate eminence (10 flat, 10 prominent and 10 very prominent) were randomly selected and radiological tests were performed by computed tomography (Pöschl projection) and subsequent dissection by milling until the apex of the superior semicircular canal was found, establishing, with both methods, the anatomical relationship with the arcuate eminence. Results The arcuate eminence was classified as: smooth, when there was no relief (1.7%); flat, measured less than 1 mm (20.3%), prominent, measured between 1 and 2 mm, in (62%), and very prominent, measured above 2 mm (12.6%). The tomographic study (CT) and its subsequent dissection by bone milling showed a direct relationship between the arcuate eminence and the semicircular canal only when it was flat, while the rest of the types corresponded to the presence of pneumatized peri-labyrinthine cells and/or cancellous bone without a direct anatomical relationship with the apex of the superior semicircular canal. Conclusion The correlation between the arcuate eminence and the superior semicircular canal is direct only when it is flat (1 mm), being related to peri-labyrinthine cells and/or cancellous bone when the arcuate eminence is prominent or very prominent.

Exploring the Science of Marma - An Ancient Healing Technique: Definition and Properties of Marma

In the vast sea of the knowledge of Ayurveda, Marma is one of the extremely important topics. Marma points have been unanimously accepted as the ‘seats of life’ (Prana - the vital life force). If these locations are injured, then it may lead to severe pain, disability, loss of function, loss of sensation, or death. Therefore, the ancient scriptures have strictly directed that these vital locations should not be injured, and due care should be taken in this regard even while doing surgeries. However, recent researches indicate that if there is inflammation or pain at any Marma point, then stimulating its nearby Marma points can help in alleviating this pain. This Marma Therapy has been used in treating various physical and mental disorders, with encouraging results. In view of the importance of Marma Science mentioned in scriptures and with regards to surgeries, as well as the encouraging outcomes of Marma Therapy in recent times, the present study was undertaken for an in-depth study of the Science of Marma. Part-1 of this study gave an account of various ancient / classical Indian scriptures that mention different aspects of the Science of Marma. The present article, which is Part-2 of this study, gives a detailed description of the number of marmas, their location, structures involved, correlation with Panchamahabhutas, classification, as well as a detailed explanation of marmaghata or viddha lakshanas (effect of trauma), as given in classical texts written during Samhita kala. The anatomical correlation with modern science is also presented.

Presence of Cheek Dimples and Absence of Palmaris Longus - An Anatomical Correlation from Dakshina Kannada, Karnataka

BACKGROUND Palmaris longus (PL) tendon agenesis varies from 5 % to 30 % in different ethnic groups worldwide. Its agenesis is associated with decreased wrist grip, pinch grip, presence of cheek dimples, difference of prevalence of agenesis with gender and handedness and with flexor carpi superficialis tendon. Student and general population surveys done in previous studies shows the association between these variables. The purpose of this study was to find out the association between the presence of cheek dimples with absence of palmaris long tendon. METHODS We examined 1200 medical and allied health students (600 males, 600 females) aged 18 - 24 years to assess the incidence of palmaris longus absence and the presence of cheek and chin dimples. The presence or absence of palmaris longus was assessed by clinical inspection using standard tests. The effectiveness of these’ standard tests’ is also tested along with wrist strength and pinch strength. RESULTS 163 students had PL agenesis. One hundred and twenty-one subjects had unilateral absence of palmaris longus (13.5 %). The tendon was absent bilaterally in 42 subjects (3.5) 77 students had either unilateral or bilateral cheek dimples out of 163 PL agenesis. The Mishra’s test is found to be most effective for properly defining the PL at wrist. CONCLUSIONS Prevalence of absence of palmaris longus is around 13.5 %. Unilateral agenesis of PL is 10 %. Absence of palmaris longus has strong association to presence of cheek dimples. Up to 45 % of PL agenesis will show either unilateral or bilateral cheek dimples. Studies on cheek dimples, panniculus carnosus are very scanty in literature; more studies might reveal interesting correlation. The grip strength of the wrist is unaffected due to palmaris longus agenesis; however, the pinch grip of 4th finger with thumb appears to be certainly decreased. Mishra’s test proves to be the best in demonstrating the PL. A radiant smile displaying the cheek dimples, has 50 % possibility of absence of PL. KEYWORDS Palmaris Longus Agenesis, Cheek Dimples, Bifid Zygomaticus Major, Panniculus Carnosus, Chin Dimples

Truncal pulsion in acute ischemic stroke – Clinico-anatomical correlation

Context: Truncal pulsion is a compelling sensation of being pulled to one side, in the context of normal motor and sensory functions and normal co-ordination. It is seen in a variety of ischemic strokes. Aims: This article aims at identifying ischemic stroke syndromes associated with truncal pulsion, with review of the neural substrate responsible, to help in recognition and reporting. Settings and Design: This was a prospective study conducted at Department of Neurology, at Pushpagiri institute of medical sciences and research centre, Thiruvalla, Kerala, India, over a period of 5 years, among patients with acute ischemic stroke. Methods and Material: We studied all patients with acute ischemic stroke, who were admitted to our department, over a five-year period. Patients presenting with truncal pulsion were shortlisted and were assessed by investigators independently. All patients underwent MRI brain, which was assessed by investigators 1 and 2, independently. The demographic profile, risk factors, clinical features, neuroimaging findings and outcomes were analysed using SPSSv21. Results: A total of 1456 patients with acute ischemic strokes were identified, of which 27 with truncal pulsion were included in the study. The common sites of infarction resulting in truncal pulsion were lateral medulla, cerebellum, thalamus, pons and midbrain. One patient had infarct involving anterior cingulate. Truncal pulsion was ipsilateral in infarcts involving medulla and cerebellum and contralateral in infarcts involving the pons, midbrain, mesencephalo-diencephalic junction, thalamus and cingulate. Conclusions: Truncal pulsion, a compelling sensation of falling, is a disabling symptom occurring in a variety of strokes and it poses significant challenge in neuro-rehabilitation.

Anatomical correlation between left atrium pulmonary vein ablation targets of atrial fibrillation and adjacent bronchi and pulmonary arteries by MSCT

Background The ablation targets of atrial fibrillation (AF) are adjacent to bronchi and pulmonary arteries (PAs). We used computed tomography (CT) to evaluate the anatomical correlation between left atrium (LA)-pulmonary vein (PV) and adjacent structures. Methods Data were collected from 126 consecutive patients using coronary artery CT angiography. The LA roof was divided into three layers and nine points. The minimal spatial distances from the nine points and four PV orifices to the adjacent bronchi and PAs were measured. The distances from the PV orifices to the nearest contact points of the PVs, bronchi, and PAs were measured. Results The anterior points of the LA roof were farther to the bronchi than the middle or posterior points. The distances from the nine points to the PAs were shorter than those to the bronchi (5.19 ± 3.33 mm vs 8.62 ± 3.07 mm; P < .001). The bilateral superior PV orifices, especially the right superior PV orifices were closer to the PAs than the inferior PV orifices (left superior PV: 7.59 ± 4.14 mm; right superior PV: 4.43 ± 2.51 mm; left inferior PV: 24.74 ± 5.26 mm; right inferior PV: 22.33 ± 4.75 mm) (P < .001). Conclusions The right superior PV orifices were closer to the bronchi and PAs than other PV orifices. The ablation at the mid-posterior LA roof had a higher possibility to damage bronchi. CT is a feasible method to assess the anatomical adjacency in vivo, which might provide guidance for AF ablation.

Anatomo-sonographic identification of the longissimus capitis and splenius cervicis muscles: principles for possible application to ultrasound-guided botulinum toxin injections in cervical dystonia

Objective The main objective of this study was to define and verify anatomo-sonographic landmarks for ultrasound-guided injection of botulinum toxin into the longissimus capitis (LC) and splenius cervicis (SC) muscles. Methods and results After a preliminary work of anatomical description of the LC and SC muscles, we identified these muscles on two cadavers and then on a healthy volunteer using ultrasound and magnetic resonance imaging (MRI) to establish a radio-anatomical correlation. We defined an anatomo-sonographic landmark for the injection of each of these muscles. The correct positioning of vascular glue into the LC muscle and a metal clip into the SC muscle of a fresh cadaver as verified by dissection confirmed the utility of the selected landmarks. Discussion For the LC muscle, the intramuscular tendon of the cranial part of the muscle appears to be a reliable anatomical landmark. The ultrasound-guided injection can be performed within the cranial portion of the muscle, between the intra-muscular tendon and insertion into the mastoid process at dens of the axis level. For the SC muscle, the surface topographic landmarks of the spinous processes of the C4–C5 vertebrae and the muscle body of the levator scapulae muscle seem to be reliable landmarks. From these, the ultrasound-guided injection can be carried out laterally by transfixing the body of the levator scapulae. Conclusion The study defined two cervical anatomo-sonographic landmarks for injecting the LC and SC muscles.