Placental Changes in Anemia, Gestational Diabetes and Pregnancy Induced Hypertension

Background: To assess the changes occurring in the placenta due to anemia, pregnancy induced hypertension (PIH), Gestational Diabetes Mellitus (GDM) and whether these changes were reversible with treatment when they were diagnosed in early stages. Subjects and Methods: The study is conducted in the Department of Obstetrics and Gynecology, DVVPF’s Medical College, Ahmednagar on 200 anemic patients, 180 PIH patients and 650 GDM patients. Placentae were collected, stored in a 10% formalin solution. Morphological changes in respect to shape, weight, diameter, thickness, number of cotyledons and site of insertion of the cord are observed and documented. Results: In anemic patients who has undergone treatment, there were a smaller number of irregular (37/100) and round (63/100) round placentae were seen, whereas in the untreated anemic group, round (09/100) round and irregular (91/100) irregular placentae were seen. In PIH group with treatment, round (57/90) placentae and irregular (33/90) placentae were seen, whereas, in the untreated group, 13/100 round/oval placentae were observed and 77/100 irregular placentae were seen. Conclusion: Morphology of placenta is on error mode in untreated anemia, PIH and GDM. Diagnosis in the first trimester and on consequent treatment till the delivery is resulting in decreasing of irregular morphology of placenta and wellbeing of newborns.

A CT Scan Study Showing Prevalence of Haller Cells in Patients with Sinonasal Complaints

Background: Anterior ethmoid cells that extend into the maxillary sinus roof are known as Haller cells. They are commonly seen on the floor of the orbit. They may cause sinusitis symptoms by blocking the infundibulum, may get infected and also sometimes complicate the Functional Endoscopic Sinus Surgery (FESS). The present study was undertaken to determine the prevalence of Haller cells on CT scans in patients having sino-nasal complaints. Subjects and Methods : This was a descriptive observational study carried out on 150 patients who presented with various sino-nasal complaints and underwent a CT Scan in the Department of Radiodiagnosis, Bangur Institute of Neurosciences, Kolkata. Their CT scans were studied retrospectively for the presence of Haller cells. Radiological variations data were summarized by routine descriptive statistics namely counts and percentages for categorical variables. Fisher’s Exact Tests and were applied to calculate the ‘p’ value to find out any statistically significant difference between males and females. Results: Haller cells were found in 12% (18 cases) in the present study, 5.33% in males and 6.67% in females. ‘p’ value in this case was 0.616 on applying Fisher’s Exact test. Conclusion: Anatomical variations of the paranasal sinus region like Haller cells are quite common and they must be searched for by the surgeons planning any endoscopic sinus surgery. This study attempted to provide the prevalence of the Haller cells in Eastern India which will definitely help the FESS surgery and its outcomes.

Assessment of Relation between External Branch of Superior Laryngeal Nerve & Thyroid Gland- A Cadaveric Study

Background: The thyroid gland is essential for normal growth of the body. This study assessed relation of external branch of superior laryngeal nerve to the superior pole of the thyroid gland. Subjects and Methods: This study was conducted on 25 human cadavers having 50 superior thyroid poles of both genders. Cadavers were classified based on age groups, group I was those with age less than 39 years and group II cadavers were those with age more than 40 years of age. Various measurements were performed on cadavers. Results: 14 cadavers were I group I and 11 were in group II. The mean mass was 67.2 Kgs in group I and 59.5 Kgs in group II, time elapsed after death was 481.5 minutes in group I and 476.4 minutes in group II, mean height was 1.74 meters in group I and 1.69 meters in group II, mean BMI found to be 22.3 kg/m2in group I and 20.1 kg/m2in group II. Height found to be significant between both groups (P< 0.05). The mean distance from EBSLN to cranial point of the thyroid gland was 6.66 mm in group I and 8.96 mm in group II. The mean transverse distance from superior thyroid artery to EBSLN was 3.55 mm in group I and 5.12 mm side in group II. The mean distance of the crossing point between the most cranial point of the thyroid lobe was 6.40 mm in group I and 11.47 mm in group II. The mean distance from the EBSLN to the midline of the neck was 19.80 mm in group I and 18.58 mm in group II. The mean distance from the EBSLN to the midline of the neck on the most cranial point of the cricoid cartilage was 18.77 mm in group I and 17.80 mm in group II. Conclusion: Authors found variation in measurements in left and right side in both group I and group II.

Study on Anatomical Variations of Popliteal Artery and its Branches

Introduction: Variations in branching of popliteal artery is important for the orthopaedicians, vascular surgeons and radiologists. The present study was conducted to assess the anatomical variations in popliteal artery, its terminal branching pattern. Subjects and Methods: The present cross-sectional study included 72 lower limbs received for cadaveric dissection. Anatomical variations of the popliteal artery were noted. Results: Type IA was the most common pattern seen (87.5%) followed by IB (5.6%) and IC (2.8%). One each of types IIA2, IIB and IIC were also seen. Mean length of 162.1 7.9 mm was observed from adductor magnus to the bifurcation point of popliteal artery. Conclusion: Type IA was the most common branching pattern seen in this area. However, types IB, IC, IIA2, IIB and IIC were also seen.

Variation in Branching Pattern of Splenic Artery- A Cadaveric Study

Background: Splenic artery is the largest branch of the celiac trunk in adults and is the second-largest next to the common hepatic artery in fetal life. The present study was conducted to assess variation in the branching pattern of the splenic artery. Subjects and Methods: The present cadaveric study was conducted on 54 cadavers embalmed with 10% formalin. The peritoneal cavity was opened and explored. The celiac trunk, splenic artery and its branches were noted and photographed. Results: out of 54 cadavers, 26 were males and 28 were males. The origin of the splenic artery was from the celiac trunk in 47, a superior mesenteric artery in 4 and abdominal aorta in 3 cases. The difference was significant (P< 0.05). Conclusion: Authors found that surgeons should have a thorough knowledge regarding the branching pattern of the splenic artery. There was variation in the origin of the splenic artery such as from celiac trunk, superior mesenteric artery and abdominal aorta.

A Study of Transverse Diameter of The Lumbar Spinal Canal in Plain Radiograph in Population of Telangana, India

Background: The present study was conducted to determine Transverse diameter (inter-pedicular distances) of the lumbar spinal canal measured in plain antero-posterior radiograph of 140 subjects (80 males, 60 females) aged between 20 to 60 years in population of Telangana. Subjects and Methods : The present study was conducted in the department of Anatomy, in a teaching medical college and hospital in Hyderabad, Telangana, India. It comprised of antero-posterior plain radiographs of lumbar spine of 140 subjects, aged between 20 to 60 years. Transverse diameter of the lumbar spinal canal or inter-pedicular distances (IPD), and transverse diameter of the vertebral body was measured using electronic Digital Vernier calipers, and the ratio between transverse diameter of vertebral canal and transverse diameter of the corresponding vertebral body were analyzed. Results: Out of 140 patients, males were 80 and females were 60. The mean inter-pedicular distance (IPD) at L1 was 24.2 mm in males and 23.4 mm in females, and at L5 was 30.2 mm in males and 29.6 mm in females. Mean transverse diameter of lumbar vertebral canal (I.P.D) is minimum at L1 vertebra in both sexes. The maximum values of I.P.D were recorded for vertebra L5 for both sexes. The values of IPD are higher in male population in comparison to female counterparts. The mean width of the vertebral body is gradually increasing from L1 to L5. Ratio between transverse diameter of vertebral canal and transverse diameter of the corresponding vertebral body is seen to be constant (0.6) at all lumbar level in both the sexes. Conclusion: Authors found that there is variation in the size of the lumbar vertebral canal between males and females. Even after the revolution of various imaging techniques like CT Scan, MRI, etc., the plain radiography remains the mainstay of investigative procedure particularly in rural setup.

Morphology and Anthropometry of Rhomboid Impression of Clavicle and its Clinical Applications – A South Indian Population Study

Introduction: The medial end of clavicle is connected to the upper surface of anterior end of first rib and its costal cartilage by rhomboid ligament which assist the movements of pectoral girdle as well as resist the pull of medial end of clavicle by pectoralis major and sternocleidomastiod muscles. Consequently, the attachment of it on the clavicle produces various patterns like tubercles, grooves, etc. called as the rhomboid impression. This normal variant of rhomboid impression may be interpreted sometimes as pathological lesions like necrosis, osteomyelitis, and tumour. Also, the morphology of rhomboid impression varies in different population. Such study in South Indian population is very much sparse and so this study is planned for. The objective is to it is aimed to estimate the prevalence of various morphology of rhomboid impression, to measure the anthropometry of impression and the distance from the medial end of impression to medial end of clavicle. Subjects and Methods: This descriptive study was carried in 200 adult human dry clavicles of both sides and various patterns of rhomboid impression, anteroposterior and transverse diameter of impression and distance between the medial end of impression and medial end of clavicle was measured with digital vernier caliper. Statistical analysis was done and p-value of < 0.05 is considered to be significant. Results: The most common pattern observed was depression and rough (29%) followed by elevated and rough (28.5%). The resection length of the medial end of clavicle was 11 mm from the medial end of impression to medial end of clavicle. Conclusion: The findings of the present study on the morphology and anthropometry of rhomboid impression of adult human clavicles and the resection length of medial end of rhomboid impression from the medial end of clavicle will provide guidance for the anthropologists, orthopedicians, radiologists, vascular surgeons and in forensic investigations.

Morphological and Morphometric Study of Pterion in Adult Dry Human Skulls

Introduction: Pterion is significant bony landmark because it commonly lies near the anterior branch of middle meningeal artery as well as Broca’s Area. The aim is to study the types of pterion and measure the distance from various bony landmarks on skull to the midpoint of pterion. Subjects and Methods: This study was performed on 70 adult dry human skulls of unknown age and sex. Types and location of pterion was observed bilaterally. Measurements were taken in millimeter using digital Vernier caliper from midpoint of pterion to i) fronto-zygomatic suture ii) middle of zygomatic arch iii) tip of mastoid process iv) glabella v) antero-superior margin of external acoustic meatus vi) Asterion. Results: We observed five types of pterion: spheno-parietal, fronto-temporal, stellate, epipteric and atypical. Among the skulls studied the most common type was sphenoparietal bilaterally. The mean of distances from midpoint of pterion to fronto-zygomatic suture was, 31.68 5.58 mm and 31.18 5.82 mm; to the middle of zygomatic arch was 38.87 3.63 mm and 37.84 3.99 mm; to asterion was 83.55 7.22 mm and 85.53 6.88 mm; to external acoustic meatus it was 51.70 3.20 mm and 51.37 3.39mm; to glabella it was 77.24 6.93 mm and 76.44 6.83 mm; to tip of mastoid process it was 80.77 6.10mm on the right side and 79.59 5.70 mm on the left side. Conclusion: Pterion is the most commonly used surface landmark. Findings of present study regarding classification of pterion will be helpful for neurosurgeons, radiologists, anthropologists and forensic pathologists.

Subacute Sclerosing Panencephalitis with Subclinical Infection

Subacute Sclerosing Panencephalitis (SSPE) is a chronic complication of measles. It is a neurodegenerative disorder characterized by cognitive and memory deterioration, behaviour abnormalities, involuntary movements and repetitive myoclonic jerks and a steady motor decline. We report a case of a 7-year-old girl with subacute sclerosing panencephalitis presenting with myoclonic jerks, regression of motor milestones and speech. The child was not immunised for measles. Magnetic resonance imaging revealed multiple variable-sized ill-defined T2W and FLAIR hyperintense areas are seen involving the white matter of the bilateral fronto-parietal lobes. Electroencephalograph findings and CSF analysis confirmed the diagnosis of subacute sclerosing panencephalitis.

Study on Histomorphological Findings in Placenta in Cases of Pregnancy Induced Hypertension

Introduction: PIH is a common condition associated with changes in placenta. It leads to increased perinatal mortality. The present study was conducted to assess the morphological and histopathological changes in placenta in cases of pregnancy induced hypertension. Subjects and Methods: The present comparative study included 49 cases of PIH and 49 normotensive mothers. Clinical details and placental morphology were noted. Results: That the two groups are similar with no significant difference. Placental weight and diameter were similar in PIH and control groups (p>0.05). However, placental thickness and number of cotyledons were greater in PIH group (p=0.00) while placental volume was lower with significant difference (p=0.01). PIH group showed greater proportion of infarction, calcification, hyalinised area per 10 lpf and intervillous haemorrhage (p=0.00). Conclusion: PIH leads to gross and microscopic changes in placental morphology.