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Enteric neurons and ganglia are derived from vagal and sacral neural crest cells, which undergo migration from the neural tube to the gut wall. In the gut wall, they first undergo rostrocaudal migration followed by migration from the superficial to deep layers. After migration, they proliferate and differentiate into the enteric plexus. Expression of the Rearranged During Transfection (RET) gene and its protein RET plays a crucial role in the formation of enteric neurons. This review describes the molecular mechanism by which the RET gene and the RET protein influence the development of enteric neurons. Vagal neural crest cells give rise to enteric neurons and glia of the foregut and midgut while sacral neural crest cells give rise to neurons of the hindgut. Interaction of RET protein with its ligands (glial cell derived neurotrophic factor (GDNF), neurturin (NRTN), and artemin (ARTN)) and its co-receptors (GDNF receptor alpha proteins (GFRα1-4)) activates the Phosphoinositide-3-kinase-protein kinase B (PI3K-PKB/AKT), RAS mitogen-activated protein kinase (RAS/MAPK) and phospholipase Cγ (PLCγ) signaling pathways, which control the survival, migration, proliferation, differentiation, and maturation of the vagal and sacral neural crest cells into enteric neurons. Abnormalities of the RET gene result in Hirschsprung's disease.

Endoscopic sinus and skull base Surgery has gained significant improvement widely all over the world. A computerized tomography (CT) scan provides a detailed anatomy of the skull base especially the bone framework. This study aims to analyze the fixed anatomical bony landmarks of the anterior skull base through coronal and reconstructed CT in the context of the Nepalese population and guide the surgeon to perform endoscopic sinus and skull base surgery safely. This Prospective study includes 70 Computerized Tomography scans of Paranasal sinuses. The different measurement from nasal floor to skull base was taken in coronal and reformatted sagittal CT scan. Mean, standard deviation, minimum and maximum values were analyzed using descriptive statistics. Student T-test was applied to compare between right and left side. This study includes 75 patients between 18 to 77 years. The measurement from nasal floor to the cribriform plate and ethmoidal roof in right and left side were, mean± SD (47± 4.1, 45.3±4.3, 47.9±5.1, and 49±8.5 mm) respectively. Mean Take off angle at the cribriform plate was 43.9 ±10.9°on right side and 43 ± 9.4° on the left side. The distance from the nasal spine to the skull base (mean ± SD) at nasofrontal recess, bulla ethmoidalis, and the junction of sphenoethmoid levels at right sides were 51.5 ± 4.7, 52.9 ± 4.1, and 61.2 ±4.7 little higher at left side. This study provides a detailed analysis of the anterior skull base in coronal and sagittal CT scans which helps to reduces complications.

Enteric neurons and ganglia are derived from vagal and sacral neural crest cells, which undergo migration from the neural tube to the gut wall. In the gut wall, they first undergo rostrocaudal migration followed by migration from the superficial to deep layers. After migration, they proliferate and differentiate into the enteric plexus. Expression of the Rearranged During Transfection (

Introduction: The femur is the largest and strongest bone of the body that forms the skeleton of the thigh. The morphometry of proximal end of femur are variable between different individuals with different Nationality. The aims and objective of the study is to find out the morphometric measurements- Femur Length, Femur head diameter, Femur neck shaft angle, and Femur neck length, breadth and thickness. Methods:After ethical review and permissionfrom the concerned authorities 75 femurs of both sexes were collected from the Anatomy Department, MCOMS, Pokhara. The parameters on proximal femur were measured manually with the help of measuring scale, thread, protector and vernier calliper. The collected data were analyzed with Microsoft Excel 2007 software and represented graphically. Results: In the present study, the average femoral length for entire femur was 42±2.81 cm, femoral head diameter was13.05±0.9 cm, femoral neck length was 4.12±0.32 cm, femoral neck breadth was 2.94±0.30 cm, and femoral neck thickness was 2.36±0.42 cm. There was no more difference between the dimension of proximal end of right and left femur but there was a significant difference between femur neck shaft angle of both femur. Conclusion: The results of the present study show that the dimensions of proximal femur in Nepalese Population are different as compared to other countries population. The knowledge of different dimensions of proximal femur will be important in anthropological and medico-legal practice for sex determination and as well as to radiologists and orthopaedic surgeons for diagnosis and planning of treatment.

Granule cells in the cerebellum are derived by the proliferation of cells from the rhombic lips of the metencephalon. Atonal homolog 1 (ATOH1), a protein encoding proneural gene, plays an essential role in the neurogenesis of the cerebellar granule cells. It encodes the basic helix loop helix (bHLH) family of transcription factor ATOH1. Expression of the ATOH1 gene in the rhombic lips of the metencephalon results in specification and proliferation of the granule neuron progenitors. Four major signaling pathways- Sonic hedgehog (Shh), Notch, Wingless related integration site (Wnt) and Bone morphogenetic protein (BMP) play an essential role in the regulation of the ATOH1 gene. Shh, Notch and Wnt signalings induce expression of the ATOH1 gene for the proliferation of the granule neuron progenitors whereas BMP signaling is involved in the differentiation of the granule neuron progenitors into the granule cells. Aberrant expression and mutation of the ATOH1 gene result in cerebellar medulloblastoma, the phenotype of trembling gait, cerebellar ataxia and hearing loss.

Introduction: Studies have shown self-medication to be common among medical students. These studies are however, few in Nepal. The present study assessed knowledge, attitude, and practice of self-medication among second and fourth semesters’ undergraduate medical students and studied differences in knowledge and attitude (if any) among different subgroups of the respondents. Materials and Methods: A cross-sectional survey was conducted using a questionnaire among basic science medical students of Manipal College of Medical Sciences, Nepal. Semester of study, gender, age, nationality, and the profession of their parents were noted. Students’ knowledge and attitude about self-medication was studied by noting their degree of agreement with a set of 40 statements using a Likert-type scale. The average scores and frequency of occurrence of particular behaviors among different categories of respondents were compared using appropriate statistical tests. Results: Two hundred and seventy-six of the 295 (93.6%) students participated. The mean (SD) knowledge, attitude, and total scores were 74.54 (6.92), 67.18 (5.68), and 141.73 (10.76) with maximum possible scores 100, 100 and 200, respectively. There was no significant difference in scores according to respondents’ gender, age, and the profession of their parents. However, the mean knowledge, attitude and total scores were significantly different among students of different nationalities. Mean scores of fourth semester students were significantly higher compared to second semester students. There were differences in knowledge and total scores among students of different nationalities. Eighty two percent of respondents had self-medicated during the one year period preceding the study; 149 respondents (54%) shared that previous experience with the medicine was one of the information sources for self-medication. Prevalence of selfmedication among respondents according to semester of study, gender, age, and profession of the parents was not significantly different. The use of self-medication was more common among Sri Lankan respondents compared to Nepalese. Painkillers (73.2%), antipyretics (68.8%), and antimicrobials (56.2%) were most commonly used for self-medication. Conclusion: Students’ knowledge and attitude about selfmedication is good. The prevalence of self-medication among medical students was high.

Double left renal vein is a rare venous anomaly. In 6.5% of cases double left renal vein, one in front (preaortic) and another behind the abdominal aorta (retroaortic) has been reported. The development of renal vessels is very complicated. There are extensive changes which occur in subcardinal, supracardinal and sacrocardinal veins during development that may lead to congenital venous anomalies. Here, we report a case of congenital venous anomaly of persisting retroaortic left renal vein.