Location of Major Duodenal Papilla in Human Duodenum

Context: The major duodenal papilla is one of the most fascinating papilla present at the duodenum attracting many gastroenterologists as they do endoscopic retrograde cholangiopancreatiography (ERCP) for diagnosis and treatment purpose of many diseases. Most of the textbooks of Anatomy describe that the summit of major duodenal papilla is situated posteromedially in the descending part of duodenum. Henceforth the present study was undertaken in 70 human duodenums to observe the location of major duodenal papilla. Materials & Methods: A cross-sectional observational study was conducted in the department of Anatomy, Dhaka Medical College, Dhaka from July 2010 to June 2011. Seventy postmortem human duodenums were collected from unclaimed dead bodies that were under examination in the morgue of department of Forensic Medicine and the department of Anatomy of Dhaka Medical College, Dhaka. Location of major duodenal papilla was observed and recorded. Results: The location of major duodenal papilla was observed in the medial wall of second part of duodenum in 78.6% specimens, in the posteromedial wall of second part in 15.7% cases and in the posteromedial wall of the junction between second and third part in 4.3% and absent in 1.4% duodenum. Conclusion: The location of major duodenal papilla varies in position. DOI: http://dx.doi.org/10.3329/bja.v12i1.22614 Bangladesh Journal of Anatomy, January 2014, Vol. 12 No. 1 pp 22-24

Anatomy Educational “Tools”

not available DOI: http://dx.doi.org/10.3329/bja.v12i1.22608 Bangladesh Journal of Anatomy, January 2014, Vol. 12 No. 1 pp 01-02

Study of Umbilical Cord in Pregnancy Induced Hypertension with and without Diabetes Mellitus

Context : Two organs that can provide a good insight into pregnancy induced hypertension with and without diabetes mellitus are the placenta and the umbilical cord along with their vessels. In the present study the umbilical cord is taken from the placenta of hypertensive and diabetic mothers to measure its diameter, to observe contained vessels and its mode of attachment to the placenta. Materials and Methods: An observational and analytical type of study was conducted in the department of Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka between November 2003 to May 2004 on umbilical cords. To study the umbilical cord, placentas were collected from fifty eight Bangladeshi women who gave birth to a single live baby through Caesarian section after 35 to 40 weeks of gestasion. Twenty of the mothers were non hypertensive, non diabetic control, twenty had pregnancy induced hypertension(PIH) and eighteen had pregnancy induced hypertension and gestesional diabetes mellitus(PIH+GDM). Results: No significant difference was found between any groups for diameter of the umbilical cord. All the umbilical cords had same number of vessels. There was variation among the mode of insertion of umbilical cord. Conclusion: Diameter of umbilical cords did not show significant difference in either of the two diseased groups with the control group in the Post Hoc option of analysis of variance (ANOVA) at 5% level. DOI: http://dx.doi.org/10.3329/bja.v12i1.22609 Bangladesh Journal of Anatomy, January 2014, Vol. 12 No. 1 pp 03-06

Morphometric Analysis of Dry Adult Human Mandibular Ramus

Context: Mandible is the lower jaw bone providing attachment of muscles of mastication and facial expression and provides pathway for inferior alveolar nerve and vessels. The mandibular ramus is almost vertical in adult but more oblique in old age. The anterior part of ramus can be used as the donor site for reconstruction of small bone defects in the oral and maxillofacial region. A relatively short mandibular ramus may be an important unfavorable anatomic factor in difficult laryngoscopy. The aim of this study was to determine the morphometry of mandibular ramus from various anatomical landmarks in one hundred eighty five dry adult human mandibles. Materials and Methods: A cross-sectional, analytical type of study was conducted in the department of Anatomy, Dhaka Medical College, Dhaka from July 2010 to June 2011. Morphometry of mandibular ramus was measured with the help of digital sliding calipers. Results: The mandibular ramus was at the same distance from each landmark on both sides demonstrating symmetry. There was no significant difference in the values on the right and left sides of the mandibles. Conclusion: Anatomical knowledge of this study might be useful in certain surgical procedure. DOI: http://dx.doi.org/10.3329/bja.v12i1.22612 Bangladesh Journal of Anatomy, January 2014, Vol. 12 No. 1 pp 14-16

A Cross Sectional Study on Sex Difference in sagittal Length of Second Cervical Vertebrae

Context: Examination of bone is important for identification of sex of an individual. The present study was planned to collect data regarding sagittal length of human dry ossified second cervical vertebrae and to find out possible variations in male and female. Materials & Methods: A cross-sectional analytical type of study was conducted in the department of Anatomy, Dhaka Medical College, Dhaka, from January 2012 to December 2012. The study materials consist of 156 human dry ossified second cervical vertebrae of unknown sex. The study samples were distributed in male and female sex groups by discriminant function analysis technique. Results: Among 156 vertebrae 55.77% was male and 44.23% was female. The mean (±SD) sagittal length of second cervical vertebrae was greater in male than that of female (P<0.001). Conclusion: Sagittal length of second cervical vertebra was greater in male compared to female. The differences in length can be useful in sex differentiation. DOI: http://dx.doi.org/10.3329/bja.v12i1.22610 Bangladesh Journal of Anatomy, January 2014, Vol. 12 No. 1 pp 07-10

Bangladeshi Anatomists’ Perception for Structuring the Embryology and Genetics Oral Exam of M Phil Anatomy Course

Context: Embryology and Genetics is a compulsory paper in the Master of Philosophy (MPhil) course in Anatomy in Bangladesh. Assessment of the knowledge, skills and attitudes of the students is a key component of a curriculum that is an integral part of any course design. Proper implementation of the assessment exams based on organized documents like exam format or card can make the course meaningful. The purpose of this study was to develop an exam format for structuring the oral exam to be followed by the examiners of the Embryology and Genetics paper of the MPhil Anatomy course. Materials & Methods: The descriptive study having both qualitative and quantitative components was carried out from January 2004 to June 2005 in the Department of Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka, Bangladesh. The questionnaire was distributed to all the postgraduate anatomists (sixty) all over the country excepting eleven who were participated in focus group discussion. Results: The exam format is an important tool for structuring the oral exam but from time to time it should be modified depending upon the needs and situation. DOI: http://dx.doi.org/10.3329/bja.v12i1.22616 Bangladesh Journal of Anatomy, January 2014, Vol. 12 No. 1 pp 30-34

Gross and Histomorphologic Study of the Umbilical Cord in Pre-gestational Diabetes Mellitus and Gestational Diabetes Mellitus

Objective: The umbilical cord is fetal organ and contains two arteries and one vein covered by connective tissue called Wharton’s jelly. Gestational diabetes mellitus (GDM) is a common metabolic disorder, the importance of which includes possible fetal and maternal complications. As the umbilical cord is the communicating channel between the fetus and the placenta, any pathological change in the umbilical cord may cause harm to the fetus. For this reason, some gross morphological and microscopic features of umbilical cord were analyzed in case of pre-gestational and gestational diabetes mellitus. Materials and Methods: A cross-sectional, analytical and observational type of study was carried out in the Department of Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka between July 2004 and December 2005. Total 60 umbilical cords with placentae were collected within 34 to 40 weeks of gestation from BSMMU and BIRDEM. Among these, twenty were from mothers not suffering from diabetes (Control group), twenty had pre-gestational diabetes mellitus (PDM group) and twenty were suffering from gestational diabetes mellitus (GDM group). Number of umbilical vessels were observed on the cut surface of umbilical cord later confirmed by histological examination. Presence or absence of true or false knots were noted. The umbilical cord cross sectional area, vessel areas and their luminal area were estimated. The ANOVA post-hoc option was used for statistical analyses of results. Results: Among the gross and histomorphological variables of the umbilical cord, there was no significant difference between the three groups. DOI: http://dx.doi.org/10.3329/bja.v12i1.22615 Bangladesh Journal of Anatomy, January 2014, Vol. 12 No. 1 pp 25-29

Observational Study of Variations in Termination of the Common Bile Duct in Human Cadaver

Context: The union of the distal portion of the common bile duct and the main pancreatic duct varies. They together may form short common channel or long common channel or may open separately into the second part of the duodenum. So detailed anatomical knowledge is essential for any surgical or endoscopic treatment of this region. Materials and Methods: A cross sectional descriptive type of study was carried out in the department of Anatomy, Sir Salimullah Medical College on sixty two (62) human cadaveric extra hepatic biliary apparatus with pancreatic duct. The samples were collected from unclaimed dead bodies that were under examination in the department of Forensic Medicine of Dhaka Medical College, Dhaka and Sir Salimullah Medical College, Dhaka. The present study was conducted to observe the variations in termination of common bile duct with main pancreatic duct in human cadavers. Results: The common bile duct was found to unite with main pancreatic duct within the duodenal wall in 61.3% cases and outside the duodenal wall in 38.7% cases. Conclusion: The findings of the present study revealed that the termination of the common bile duct varies from individual to individual. DOI: http://dx.doi.org/10.3329/bja.v12i1.22611 Bangladesh Journal of Anatomy, January 2014, Vol. 12 No. 1 pp 11-13

Sexual Dimorphism in Alar Length and Auricular Index of Sacrum

Context : It has long been customary among anatomists, anthropologists and forensic experts to judge the sex of the skeletal material by non-metric observations. Afterward the study of sexual divergence has been based upon actual measurements in different bones. The study in relation to metrical data on bone is very few in our country. The study was planned to observe the differences of sacra between male and female in respect to measurement of alar length and auricular index of sacrum. The findings of this study might be useful in providing morphometrical data that can be used by anatomists, forensic experts, anthropologists, orthopedic surgeons and neurologists for proper initiative in their respective fields. Materials and Methods: A cross-sectional, analytical type of study was performed in the department of Anatomy, Dhaka Medical College, Dhaka from January 2011 to December 2011. A total of 172 (one hundred seventy two) adult human dry sacra of unknown sex was assessed. The study samples were distributed in male and female sex groups by discriminant function analysis. All the samples were studied morphologically. Length of ala and auricular surface were measured with the help of digital slide calipers. Results: The mean length value of ala was greater in female than male (P<0.001). The difference between the mean value of alar index in male and female was significant (P >0.05). The mean value of auricular index was higher in male than female and the difference was statically significant (P<0.001). Conclusion: The sacrum can be used for sexual dimorphism as is usual in anthropological work. The knowledge of alar length and auricular index of sacrum is essential in medico-legal practice for sex determination of an individual. DOI: http://dx.doi.org/10.3329/bja.v12i1.22613 Bangladesh Journal of Anatomy, January 2014, Vol. 12 No. 1 pp 17-21

Identifying Qualities of a Medical Teacher

Context: Teaching is a novel profession. Teaching is a science as well as an art. In case of medical teaching it is more important as it deals with human being oriented curriculum. Products of the medical teachers will deal with life and death. So medical teachers should have such qualities as role model in-front of students. It will help students to become future physicians with professionalism which the medical profession and people expect from them. Materials & Methods: A descriptive type of cross sectional study was conducted in different government and nongovernment medical colleges of Bangladesh to identify the qualities of medical teachers. The study population was the teachers of MBBS course who were working at least one year in medical colleges and were willing to co-operate and were available at the time of data collection. Sample size was 437. Self-administered structured questionnaire was used for the collection of data from the teachers. There were few open ended questions also. Results: Study revealed the generic fundamental qualities of a medical teacher are competent in respective subject, teach medical students daily, ethical person, nonthreatening attitude, assess the student in unbiased way, strength of personality, updated with relevant recent knowledge, not involve in grouping, preparing and presenting audio visual aids to make the teaching sessions attractive, strength of good communication (verbal, nonverbal, writing etc.), conduct research regularly, publish article in journals every year, act as role model, friendly with the colleagues, supportive for the staff, co-operate rationally with the administration, justified decision maker and good basic clinical care provider. Study also revealed the specific qualities of a medical teacher are sympathetic & empathetic dealings of a teacher towards patients, counsel to motivate students to be a self directed learner, motivate students for positive extracurricular activities (outdoor/indoor games, cultural functions, wall magazine, debate etc.), well behalf manager, fair personalities, wear decent well dress and not actively involved in politics. DOI: http://dx.doi.org/10.3329/bja.v11i2.20677 Bangladesh Journal of Anatomy, July 2013, Vol. 11 No. 2 pp 86-91