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Doxorubicin is a widely used anticancer drug whose efficacy is limited due to its cardiotoxicity. There is no ideal cardioprotection available against doxorubicin-induced cardiotoxicity. This study aimed to investigate the anticipated cardioprotective potential of metformin and dapagliflozin against doxorubicin-induced acute cardiotoxicity in Wistar rats. At the beginning of the experiment, cardiac screening of experimental animals was done by recording an electrocardiogram (ECG) before allocating them into the groups. Thereafter, a total of thirty healthy adult Wistar rats (150–200 g) were randomly divided into five groups (n = 6) and treated for eight days as follows: group I (normal control), group II (doxorubicin control), group III (metformin 250 mg/kg/day), group IV (metformin 180 mg/kg/day), and group V (dapagliflozin 0.9 mg/kg/day). On the 7th day of the treatment phase, doxorubicin 20 mg/kg was administered intraperitoneal to groups II, III, IV, and V. On the 9th day (immediately after 48 h of doxorubicin administration), blood was collected from anesthetized animals for glucose, lipid profile, CK-MB & AST estimation, and ECG was recorded. Later, animals were sacrificed, and the heart was dissected for histopathological examination. We found that compared to normal control rats, CK-MB, AST, and glucose were significantly increased in doxorubicin control rats. There was a significant reversal of doxorubicin-induced hyperglycemia in the rats treated with metformin 250 mg/kg compared to doxorubicin control rats. Both metformin (180 mg/kg and 250 mg/kg) and dapagliflozin (0.9 mg/kg) significantly altered doxorubicin-induced ECG changes and reduced the levels of cardiac injury biomarkers CK-MB and AST compared to doxorubicin control rats. Metformin and dapagliflozin protected the cellular architecture of the myocardium from doxorubicin-induced myocardial injury. Current study revealed that both metformin and dapagliflozin at the FDA-recommended antidiabetic doses mitigated doxorubicin-induced acute cardiotoxicity in Wistar rats. The obtained data have opened the perspective to perform chronic studies and then to clinical studies to precisely consider metformin and dapagliflozin as potential chemoprotection in the combination of chemotherapy with doxorubicin to limit its cardiotoxicity, especially in patients with comorbid conditions like type II diabetes mellitus.

Pelvi-ureteric junction obstruction is not a rare clinical entity. It is indeed one of the common urological conditions presenting most commonly as hydronephrosis and pain. The most common etiology for patients suffering from acquired pelvi-ureteric junction obstruction is the presence of calculus/calculi. An aberrant renal vessel (now termed as Vascular bar) is one of the causes in adults which is often missed on pre-operative investigations and is detected intra-operatively. We present herein, a case report of a 28 years old female who came with complaints of loin pain since 2 to 3 months. The workup investigations revealed only hydronephrosis without any calculi. Thus a diagnosis of primary pelvi-ureteric junction obstruction was made. The patient was successfully managed by a laparoscopic pyeloplasty. Keywords : PUJ obstruction, Vascular bar, aberrant renal vessel, laparoscopic pyeloplasty

Introduction: Differences in pain thresholds may have implications in pain management, as they may account in part for the variability in analgesic requirements between individuals. We planned to investigate the influence of endogenous sex hormones on the analgesic modulation of tramadol in lean and high-fat diet-induced obese Wistar rats. Methods: The whole study was carried out on 48 adult Wistar rats (24 male- 12 obese & 12 lean and 24 female- 12 obese & 12 lean). Each male and female rat group was further subdivided into two groups (n=6/group) and treated with normal saline/tramadol for five days. On the fifth day, 15 minutes after tramadol/normal saline treatment, animals were tested for pain perception towards noxious stimuli. Later, endogenous 17 beta-estradiol and free testosterone levels in serum were estimated through ELISA methods. Results: The present study revealed that female rats experienced more pain sensitivity to noxious stimuli compared to male rats. High-fat diet-induced obese rats experienced more pain sensations to noxious stimuli than lean rats. Obese male rats were found to have significantly low free testosterone and high 17 beta-estradiol levels compared to lean male rats. An increase in serum 17 beta-estradiol level led to increased pain sensation to noxious stimuli. While an increase in free testosterone level resulted in the lowering of pain sensation to noxious stimuli. Conclusion: The analgesic effect of tramadol was more pronounced in male rats compared to female rats. The analgesic effect of tramadol was more marked in lean rats compared to obese rats. Additional research to elucidate obesity-induced endocrine changes and the mechanisms driving sex hormones in pain perception is needed to foster future interventions to reduce disparities in pain.

Myelosuppression by doxorubicin is a life-threatening adverse effect in cancer patients undergoing chemotherapy. Methyl gallate is an antioxidant found in a variety of plant species. The study aimed to demonstrate the protective role of methyl gallate on doxorubicin-induced cytopenias in Wistar rats. The animals were prophylactically treated with two different doses of methyl gallate (150mg/kg/day and 300mg/kg/day) orally for seven days. Doxorubicin (25mg/kg; single dose) was administered through intraperitoneal route on the seventh day to induce cytopenias. Blood was collected 24 hours after the administration of doxorubicin and complete blood counts were estimated. There was significant (p≤0.05) development of peripheral cytopenias in doxorubicin treated control rats compared to normal saline treated control rats. Methyl gallate at both the doses significantly (p≤0.05) mitigated doxorubicin induced cytopenias compared to doxorubicin treated control rats. The findings of the present study revealed that methyl gallate has protective role in doxorubicin-induced cytopenias in Wistar rats. Following clinical studies, methyl gallate may serve as a viable alternative to growth factors in patients undergoing chemotherapy.

Doxorubicin (DOX) is a potent anti-cancer antibiotic that was widely used for treatment of various cancers. It produces free radicals which result in extreme dose-limiting cardiotoxicity. This study investigated the cardioprotective potential of chia seed oil, an active polyphenolic nutraceutical against doxorubicin-induced cardiotoxicity in Wistar rats. Twenty-four female Wistar rats were divided into four groups (n = 6) which consist of normal control, DOX control, test-A and test-B group. Animals were prophylactically treated with two different doses of test drug, i.e. chia seed oil 2.5 ml/kg/day and 5 ml/kg/day in test-A and test-B groups orally for 7 days. Doxorubicin (25 mg/kg; single dose) was administered intraperitoneally to DOX control, Test-A and Test-B animals on the seventh day to induce cardiotoxicity. ECG analysis was done before and after treatment. Besides ECG, CK, CK-MB, LDH, AST, MDA and GSH were analyzed. DOX had significantly altered ECG, CK, CK-MB, LDH, AST, MDA and GSH. Pre-treatment with chia seed oil significantly alleviated DOX-induced ECG changes and also guarded against DOX-induced rise of serum CK, CK-MB and AST levels. Chia seed oil alleviated histopathological alteration in DOX-treated rats. It also significantly inhibited DOX-induced GSH depletion and elevation of MDA. The present study revealed that chia seed oil exerts cardioprotection against doxorubicin-induced cardiotoxicity in female Wistar rats. Our study opens the perspective to clinical studies to precisely consider chia seed oil as a potential chemoprotectant nutraceutical in the combination chemotherapy with doxorubicin to limit its cardiotoxicity.

Initial perceptions of physicians can affect the level of comfort. Creating a strong rapport on the child's first visit helps to create a comfortable atmosphere. Child-friendly clothing of the dentists might possibly contribute to the dentist's empathy. Different attires may evoke different feelings. Hence, the purpose of the study was to assess the children's preferences for dentist's attire and its relation with anxiety.Eighty children aged 5-12 years were included in the study. Five photographs of dentists wearing different attires were placed in the same order for every child. The child was asked to look at the photographs and decide which dentist they would prefer to take care of them. A facial image scale was used to evaluate the child's anxiety level. The children were asked to point at which face they felt almost like at that moment.42.7% of males and 38.5% of females chose child-friendly attire. The least preferred by males was a pink apron (7.5%) compared with females (28.1%). Whereas the blue apron was least preferred by females (5.1%) compared with males (20%). A Chi-square test was done to access the association between dental anxiety and the dental attire the children chose, where statistically significant (0.030) results were found. Anxious children were found to prefer child-friendly attire.Although the view that children are fearful of the white coat was not found, the concept of child-friendly attire might be more appropriate for anxious children and enhance an easy first communication with them.Sujatha P, Nara A, Avanti A

Nowadays influence of gender and obesity on pain perception have been received substantial pragmatic attention. This may have implications for pain management among individuals. This systematic review was aimed to analyse the impact of gender and obesity on pain perception. The electronic databases of the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and EMBASE were searched using combinations of terms for gender, sex hormones, obese, body mass index, leptin, analgesic requirements, endogenous opioids, pain measurement, and pain perception/sensitivity/threshold. Studies without comparison as well as cross-sectional studies, case series, and case reports were excluded. In the context of summary of results of extensive literature search, we found that pain sensitivity against noxious stimuli is more experienced in obese as well as females whereas it is less experienced in lean as well as males. We also found that sex hormones have influence on leptin levels whereas leptin do not affect the level of sex hormones. This review reveals that from gender perspective sex hormones and from obesity perspective leptin play an important interlinked role in pain modulation. Gender and body mass index specific tailoring of pain treatments might become a conceivable outcome in the foreseeable future

Introduction Communications between iliac veins in the pelvis are reported to be rare occurrences, which are mostly due to developmental abnormalities. The common iliac vein is formed by the joining of the internal and external iliac veins. Here, we present a detailed morphological and histological study of a rare communication found between the internal and external iliac veins, which would prove to be of substantial value to the knowledge of vessels in the pelvis, both for clinicians and surgeons. Materials and Methods In the present study, we came across a rare communication in the form of a ladder, between the left internal and external iliac veins in a 70-year-old male cadaver. There were two communications (named upper and lower communications) between the external and internal iliac veins, before they joined to form the common iliac vein. On naked eye observation, the lumen of the right common iliac vein appeared to be wider than on the left side. The lengths of these communications and the distance between each of their attachments have been measured and tabulated. The walls of these veins, their microscopic sections and their communication involved in the case were taken. The possible causes for these variations were congenital, owing to the complicated nature of the developmental process involved in the formation of the inferior vena cava and the venous system of the lower limb. Results The structure of all the veins involved in this case and the communications were seen to be normal. The thickness of these walls were measured and tabulated for uniformity around the circumference of the wall of these veins. All the measurements from the structural variations and from the histological observations are tabulated in our results. Conclusion The complicated development sequence of these veins could have possibly led to the persistence of these communications. Such a developmental variation does not seem to pose any threat until unless encountered under clinical or surgical interventions, as the histological structure of the walls of the communications as well as the major channels connected appeared to be normal and well-developed. The detailed morphological and histological features of these structures involved in the variation along with the possible complications have been presented in the present report. Knowledge of these variations and complications due to injury plays a key role in a clinical setup.

Doxorubicin-induced cardiotoxicity is the leading cause of morbidity and mortality among cancer survivors. The present study was aimed to investigate the cardioprotective potential of methyl gallate; an active polyphenolic nutraceutical, against doxorubicin-induced cardiotoxicity in Wistar rats. Twenty-four female Wistar rats (150–200 g) were divided into four groups (n = 6) which consist of normal control (group I), doxorubicin control (group II), test-A (group III), and test-B (group IV). Group III and group IV animals were prophylactically treated with methyl gallate 150 mg/kg/day and 300 mg/kg/day orally, respectively, for seven days. Doxorubicin (25 mg/kg; single dose) was administered through an intraperitoneal route to group II, III, and IV animals on the seventh day to induce acute cardiotoxicity. On the 8th day, besides ECG analysis, serum CK, CK-MB, LDH, AST, MDA, and GSH were assayed. Following gross examination of isolated hearts, histopathological evaluation was performed by light microscopy. A significant ( p p

Introduction Retroperitoneal fibrosis (RPF) is a rare fibro-inflammatory condition which is characterized by development of extensive fibrosis throughout the retroperitoneum. It is classically centred over the anterior surface of the fourth and fifth lumbar vertebrae. It results in entrapment and extrinsic compression of retroperitoneal structures. Presentation of the case We present the case of a 69 years old man who was reported to have right pelvi - ureteric junction obstruction on computed tomography, but turned out to have RPF. Discussion Retroperitoneal fibrosis commonly causes obstructive uropathy (either unilateral, bilateral or progressing from unilateral to bilateral) and if untreated, renal failure. It has high response/remission rates to glucocorticoid therapy. However, relapse rates are also high. Hence, close surveillance with serial laboratory and imaging investigations, after achieving remission, is key to long term disease control. Conclusion Although classical imaging findings, supportive laboratory markers and suggestive/diagnostic histopathology appearances for RPF are well documented, its accurate preoperative diagnosis is not always an assured certainty., Highlights • This case is unique in that the original plan to perform a laparoscopic pyeloplasty, purportedly for right pelvi-ureteric junction obstruction; was aborted ‘on table’ and a laparoscopic ureterolysis performed, instead. • Though ureteral involvement is bilateral in most cases of retroperitoneal fibrosis, this case is rare and unique in that the patient had unilateral involvement of his ureter (right sided). • Periaortic fibro-inflammatory mass at the level of the lumbar vertebrae is the hallmark of primary / idiopathic retroperitoneal fibrosis. However in this case, no such imaging finding was noted. Instead, the patient had just obvious unilateral (ride sided) disease on pre-operative imaging.

Introduction: Lumbar plexus involves the L1 - L5 spinal segments for the formation of the nerves which supply parts of the abdominal wall, pelvis and the upper part of the thigh (both sensory and motor). Our aim in this study was to compile all the rare variations found in a single cadaver, which is of the rarest possible kind. Methods: During the dissection of the abdomen and pelvis in approximately 70 year old cadaver, there were multiple variations observed in the anatomy of the lumbar plexus. The entire region was cleaned for visibility of the variations and all those were clearly documented for compiling purpose. Results: The following variations in the formation of the lumbar and sacral nerves were observed. 1. The genitofemoral nerve bifurcated at a higher level; genital branch of genitofemoral nerve gave branches to the anterior abdominal wall muscles, 2. A communicating branch was given from the lateral cutaneous nerve of thigh to the medial cutaneous nerve of thigh, 3. A muscular branch was given from femoral nerve to psoas major, 4. There was absence of contribution of L4 spinal nerve in the formation of the lumbosacral trunk, and 5. Lumbosacral trunk gave communicating branches to the femoral and obturator nerves. Most of the variations found were rare and finding all the above said variations in a single cadaver is even rare. Conclusion: Knowledge of the normal anatomy and any possible variations would help the clinicians and surgeons dealing with this region and avoid possible complications beforehand.

Introduction: Meckel's diverticulum or ileal diverticulum is one of the common congenital anomalies of the digestive system. It may not cause any problems in many, but may form serious life threatening complications in a few. Materials and Methods: We conducted a histo-morphological study of a giant Meckel's diverticulum found during cadaveric dissections of a South Indian adult male cadaver. The diverticulum was 7.5 cm long and had a circumference of 1.5 cm. Results: Gross anatomical and histological observations revealed healthy nature of the diverticulum without any inflammation. However, the mucosa had gastric type of glands with plenty of parietal cells. This incidence of Meckel's diverticulum was noted in only one cadaver among more than 100 cadavers dissected in the past twenty years. Conclusion: Knowledge of its morphological features may be very useful to surgeons, radiologists and gastroenterologists. We discuss the clinical importance of the diverticulum and review the relevant literature in this manuscript.

Knowledge of congenital anomalies of duodenum and biliary apparatus is useful in radiological diagnosis and surgical procedures of upper abdominal region. We present concurrent variations of duodenum, bile duct and coeliac trunk in this report. The first part of the duodenum descended downwards in front of the head of the pancreas. At the lower end of the head of the pancreas, it ascended upwards along the right border of the head of the pancreas until the first lumbar vertebra. At the level of first lumbar vertebra, it continued to the left as its third part. The third and fourth part passes behind the head, neck and the body of the pancreas (and also behind superior mesenteric vessels). On the left side of the second lumbar vertebra, the duodenum continued as jejunum at the duodenojejunal flexure. The common bile duct coursed down in front of the head of the pancreas, being surrounded by a few pancreatic acini in the lower part of its course. It terminated at the hepatopancreatic ampulla, which opened into the first part of the duodenum. The coeliac trunk passed through the body of the pancreas before it divide into its terminal branches.

Knowledge of variations of azygos and hemiazygos veins is of importance to cardiothoracic surgeons and radiologists during various surgical, radiological, and echography techniques. We report some unique variations of azygos system of veins observed during dissection classes for undergraduate medical students. The azygos vein was formed as usual by the union of right subcostal and ascending lumbar veins. The vein ascended upward and to the left to reach the midline at the level of the 9th thoracic vertebra. After ascending till 5th thoracic vertebra, it gradually inclined to the right of midline and terminated by opening into the superior vena cava at the level of the 3rd thoracic vertebra. There was no major variation in the tributaries of the azygos vein on the right side, except that the right superior intercostal vein crossed behind the azygos vein from right to left and opened into the left side of the azygos vein. Further, two anastomotic veins connected the 10th, 11th and 12th posterior intercostal veins with each other to form two anastomotic circles on the right side of 10th to 12th thoracic vertebrae. The hemiazygos vein bifurcated on the left side of the 10th thoracic vertebra and the two ends opened into the azygos vein at the level of 9th and 10th thoracic vertebrae forming a venous circle in front of the 10th thoracic vertebra. The course of accessory hemiazygos vein was noteworthy. Instead of its classic descending course, the vein ascended upward from the left side of the 8th thoracic vertebra till the 6th thoracic vertebra before opening into the azygos vein.

Introduction: Hepatic veins are the major linking vessels between systemic and portal circulation. Numerical and positional variation of the hepatic veins can play a signifi cant role during surgical interventions on the liver. Materials and Methods: Gross anatomical study regarding the number and arrangement pattern of hepatic veins was undertaken on 88 adult livers which were stored in 10% formalin after the regular dissection classes. Result: Six livers (7%) were found to be drained only by major hepatic veins, whereas 82 out of 88 livers (93%) had accessory (minor) hepatic veins. The total number of persistent hepatic veins ranged from 2 to 10 with the highest prevalence of four hepatic veins (35.2%) followed by 5 (19.3%) and 6 (17%). The presence of three major veins was seen in 45 (51%) livers while 41 (47%) livers had two major hepatic veins. Remaining two livers (2%) showed the presence of four major hepatic veins. In 95% specimens, the minor hepatic veins entered the inferior vena cava below the lev l of entry of major veins. In 2.5% cases, their entry point was above the major veins and in 2.5% cases, the entry point was below major veins. Conclusion: The data resulting from this study provides a clear idea about the number and drainage pattern of the hepatic veins into the liver. Knowledge of numerical and positional variations of hepatic veins could be useful in normal Doppler ultrasound hepatic vein fl ow velocities and their variation with respiration in healthy adults as comparable with the similar approach of superior vena cava.

Introduction Mesial drifting of molar teeth in maxillary arch is corrected by movement of the molars distally. In addition to traditional distal movement techniques, such as extraoral force application and removable appliances, various intra-arch devices have been introduced since 1980s. These intra-arch appliances have nearly eliminated the need for patient cooperation. Case report The purpose of this paper is to report a case of 10-year-old male patient with loss of space in maxillary molar teeth treated by intra-arch appliance-pendulum appliance by distalization of maxillary first permanent molar teeth. Distaliza-tion of the permanent molar teeth helped in proper eruption of second premolar teeth without any extensive treatment procedures. Conclusion In the present case report, the treatment of developing malocclusion was corrected by utilizing the concept of interceptive orthodontics. Hence, correction of space loss in mixed dentition period using pendulum appliance can eliminate the fixed orthodontic therapy. How to cite this article Paranna S, Shetty P, Anandakrishna L, Rawat A. Distalization of Maxillary First Permanent Molar by Pendulum Appliance in Mixed Dentition Period. Int J Clin Pediatr Dent 2017;10(3):299-301.

Persistence of jugulocephalic vein is one of the extremely rare variations of the cephalic vein. Knowledge of such a variation is of utmost importance to orthopedic surgeons while treating the fractures of the clavicle, head and neck surgeons, during surgery of the lower part of neck, for cardiothoracic surgeons and radiologists during catheterization and cardiac device placement. We report the persistent jugulocephalic vein in an adult male cadaver, observed during the routine dissection classes. The right cephalic vein ascended upwards, superficial to the lateral part of the clavicle and terminated into the external jugular vein. It also gave a communicating branch to the axillary vein below the clavicle. We discuss the embryological and clinical importance of this rare variation.

SUMMARY: Accessory meningeal artery is a branch of the first part of the maxillary artery. It supplies the structures in the infratemporal fossa and the dura mater in the middle cranial fossa. Accessory meningeal artery arose from the middle meningeal artery, 25 mm below the base of the skull and entered the middle cranial fossa through the foramen ovale. The two roots of the auriculotemporal nerve looped around it. The knowledge of the variant origin and relations may be useful during the surgeries of the infratemporal fossa. It might also be useful to the radiologists.

The superficial veins of the lower limb can vary in their course and termination. We report a relatively rare type of variation in the course and termination of small saphenous vein. The small saphenous vein had normal origin and course in the leg. However, instead of terminating into the popliteal vein, it continued up in the posterior compartment of the thigh and terminated into the femoral vein after piercing the fleshy part of the adductor magnus muscle. This course might lead to varicosity of the small saphenous vein due to the compression by the fleshy fibres of adductor magus near its termination. The case may be of interest to general and plastic surgeons and even cardiothoracic surgeons.

Aims The purpose of this study was to evaluate the accuracy of a new-generation electronic apex locator (iPex) to determine working length in primary teeth with or without root resorption as compared with the conventional radiographic method. Materials and methods A sample of 30 primary posterior teeth which are indicated for pulpectomy were selected for the study. After obtaining the informed consent from the parents, local anesthesia was administered. Access cavity was prepared with no.10 round bur. Initial exploration of the canals was done with no.10 K-file. Pulp was extirpated with a barbed broach followed by thorough irrigation of the canals with 0.9% saline. Initially, working length was obtained with iPex (new-generation by Nakanishi International) apex locator using no.10 K-file, which was then compared with conventional radiographic method (Ingle's method). Results A total of 65 canals were available for the measurement. The data were analyzed using Statistical Analysis system and t-tests were carried out. There was no statistically significant difference found when using iPex apex locator for working length determination as compared with that of conventional radiographic method (p = 0.511). Conclusion Working length determined by iPex apex locator is comparable with that of conventional radiographic method, hence, can be used as an alternative in determining the working length of primary teeth. How to cite this article Bhat KV, Shetty P, Anandakrishna L. A Comparative Evaluation of Accuracy of New-generation Electronic Apex Locator with Conventional Radiography to determine Working Length in Primary Teeth: An in vivo Study. Int J Clin Pediatr Dent 2017;10(1):34-36.

Peroneus tertius (PT) is frequently used as a free muscle flap to treat the soft tissue defects and osteomyelitis, in the lower limb as it is functionally insignificant while balancing the foot during walking. The morphology of the PT is highly variable. In the present case we report a rare case of unusual morphology of the PT in a formalin embalmed male cadaver. At the level of ankle, PT divided into three tendons; two of them were inserted to the base of the distal phalanx of the fifth toe and base of the fifth metatarsal bone respectively. The smaller third tendon was attached to the fascia covering the capsule of the ankle joint. Further, extensor digitorum longus (EDL) gave only three tendinous slips for the second, third and fourth toes.

Knowledge of normal and anomalous formation of brachial plexus and its branches is of utmost importance to anatomists, clinicians, anesthesiologists and surgeons. Possibility of variations in the origin, course and distribution of branches of brachial plexus must be kept in mind during anesthetizing the brachial plexus, mastectomy and plastic surgery procedures. In the current case, the medial pectoral nerve arose directly from the middle trunk of the brachial plexus and the lateral pectoral nerve arose from the anterior division of the upper trunk of the brachial plexus. The lateral pectoral nerve supplied the pectoralis major and the medial pectoral nerve supplied pectoralis major and pectoralis minor muscles through two separate branches.

Introduction The arch of the aorta is situated in the superior mediastinum and it normally branches into three: the brachiocephalic trunk, left common carotid artery, and the left subclavian artery. Variations in its morphology and branching pattern are mainly due to the errors in its embryologic development. Here, we report concurrent variation in the morphology and branching pattern of the aortic arch. Case report The first branch of the aortic arch was a common trunk which divided into the brachiocephalic trunk and the left common carotid artery. There was a constriction in the aortic arch immediately to the left of this common trunk. The left vertebral artery arose from the aortic arch, dorsolateral to the origin of the left subclavian artery. At the root of the neck, the left vertebral artery passed behind the first thoracic and inferior cervical sympathetic ganglia. Conclusion Knowledge of these variations may be very useful to surgeons involved in the cervical and thoracic sympathectomies, vascular surgeries, and cardiac catheterization procedures.

Introduction Intrinsic and extrinsic muscles of the hand show frequent variations. Knowledge of these muscle variations is important during diagnosis and treatment of carpal tunnel syndrome, hand surgery and some plastic surgery procedures. We report here the presence of an anomalous muscle in the hand between the first and second lumbricals. Case report The flexor digitorum superficialis had five tendons and the two lateral-most tendons among them gave origin to this abnormal muscle of the hand. The fleshy belly of the muscle was supplied by a branch of the median nerve. Distally the tendon of the anomalous muscle and most of the lateral tendon of the flexor digitorum superficialis muscle merged with the second tendon of the flexor digitorum superficialis muscle. The common tendon was inserted to the base of the middle phalanx of the index finger. Further, the first lumbrical had two heads: a lateral head and a medial head. The lateral head took its origin from the lateral-most tendon of the flexor digitorum profundus muscle and the medial head took origin from the lateral part of the fleshy belly of the abnormal muscle. Its insertion and nerve supply were normal. Conclusion The abnormal muscle can produce a bulge in the palm and it might compress the median nerve in the carpal tunnel, resulting in carpal tunnel syndrome.

Editorial The medical field is being brushed with various researches which provide us novelty in the specific field. Obser- vational studies or incidental findings are accepted as case reports for publi- cation. These findings are encountered during clinical and surgical practice, diagnostic procedures and dissection. A well-designed case report can easily cross all the barricades on the way of publication procedures. Hence, it is important to conceptualise and design a case report. This article highlights the basics requirements to construct the case report. Conclusion Case reports are indispensable resources in the medical literature. Case report serves not only to pub- lish rare or unusual observation, but also, essential, to report frequency of rare occurrence.

Introduction: Though vascular variations of gallbladder and liver are well documented in the literature, the knowledge of incidence of rare vascular variations related to them is clinically important while planning the open and endovascular procedures involving these organs. This study reports a case of variant origin of a common trunk of the accessory hepatic artery and cystic artery from the superior mesenteric artery. Case report: During the cadaveric dissection, we came across a rare vascular variation in the supracolic compartment of the abdomen. A common trunk of accessory hepatic artery and cystic artery arose from the right margin of the superior mesenteric artery. It coursed upwards behind the head of the pancreas and first part of the duodenum and entered into the right free margin of the lesser omentum. It finally entered into the substance of the right lobe of the liver. Before entering into the liver, it gave a branch at the level of the Calot’s triangle, to supply the gallbladder. Conclusion: The variant origin of the common trunk of accessory hepatic artery and cystic artery, along with its unusual course in relation to the Calot’s triangle is clinically important during laparoscopic and open cholecystectomy procedures.

The superior gluteal nerve (SGN) arises from the sacral plexus and enters the gluteal region above the piriformis where it divides into superior and an inferior branches. Former ends in the gluteus medius and occasionally gluteus minimus whereas latter supplies gluteus medius and minimus and ends in tensor fascia latae. Variations, relations, branching pattern and length of the SGN were reported in earlier studies. The present study was conducted to establish preliminary data on the length and branching pattern of the SGN and its relations with the neighbouring bony landmarks. Twenty two lower extremities were examined in 22 male and 13 female formalin fixed cadavers. Tip of the greater trochanter was determined as the point of reference. Statistical analysis was done using student's T test. Present study will help orthopedicians performing total hip replacement through lateral and transgluteal approaches (Tab. 3, Fig. 4, Ref. 19).

Introduction: Knowledge of vascular variations near the kidney is of importance to many clinical disciplines such as nephrologists, radiologists, gastroenterologists, and general surgeons. Variant branches of the abdominal aorta and renal arteries are the victims of iatrogenic bleeding during surgery. We found multiple vascular variations in the upper part of the abdomen during our dissection classes. Methods: During the dissection classes of the abdomen for undergraduate medical students, we observed multiple vascular variations in the abdomen of an adult male cadaver. The vessels and surrounding viscera were cleaned using dissection instruments. Variations observed were photographed. Results: The right kidney had its hilum directed posteriorly. There were two right renal veins and a partially doubled left renal vein (LRV). The left suprarenal and gonadal veins drained into the upper LRV. There were two right renal arteries. Upper right renal artery gave origin to the right inferior phrenic and middle suprarenal arteries. There were two renal arteries on the left side also. The left upper renal artery gave a polar branch to the left kidney and divided into two branches before entering the kidney. The left inferior phrenic artery (IPA) gave two gastric branches to the fundus of the stomach. Conclusions: The variations noted by us are of tremendous surgical application. The variant vessels might get damaged during surgical procedures if the surgeons are not aware of these variations. The most important among the variations reported here is the gastric branch of the IPA, which has not been reported yet.

Phthalates are a class of industrial compounds with an array of toxicological properties used in day to day life. Diisobutyl phthalate on (DIBP) is used as an additive to keep the plastics soft or fl exible (plasticizer) in nitrocellulose plastic, nail polish, explosives, lacquer manufacturing etc. Although DIBP exposure in humans is generally low, people in adhesive industries and pharmaceutical industries are exposed to higher levels. The aim of this study was to determine the effect of single dose of DIBP on developing ovary of Wistar rat. One hundred and eight adult pregnant Wistar rats were divided into control and experimental groups. Rats in experimental group were given DIBP on day 10, 12 and 14 of gestation at 0.375, 0.75 and 1.25 ml/kg body weight dose intraperitoneally in a single dose. Sections of ovaries collected on day 21 of gestation were stained with hematoxylin and eosin and examined and Masson’s trichrome histologically. Sections belonging to the control group showed the presence of oocytes in clusters separated by thin fi brous septa. Degeneration oocytes, empty follicles surrounded by follicular cells without gonocytes in the center were observed in ovarian stroma. Blood vessels in the ovarian stroma were prominent and congested. Around a bunch of follicles total architectural disarray was observed although on special staining fi brosis was not evident. As pregnant women are constantly exposed, effect of DIBP on ovary of a developing fetus would denote the long term consequence in future generations (Fig. 5, Ref. 39). Full Text in PDF www.elis.sk.

El incremento del uso de diagnosticos invasivos y procedimientos de intervencion en las enfermedades cardiovasculares hace que sea importante que el tipo y la frecuencia de las variaciones vasculares esten bien documentados y entendidos. Un buen conocimiento de las variaciones neurovasculares es importante para los cirujanos que extirpan linfonodos axilares, para anestesiologos y cirujanos ortopedicos, considerando la frecuencia de los procedimientos realizados en esta region. Una inusual variacion en el patron de ramificacion de la arteria axilar se observo en el lado izquierdo de un cadaver de sexo femenino de 60 anos de edad. En el presente caso, el curso y la distribucion de la primera y segunda parte de la arteria axilar fueron normales. Sin embargo, fue encontrado en el lado izquierdo, durante la diseccion de rutina, un caso raro, de origen inusual, de las arterias subescapular cirunflejas humerales anterior y posterior, braquial profunda y arterias colaterales ulnares desde un tronco comun. Este tronco comun se encontro derivado de la tercera parte de la arteria axilar y en su comienzo se comprobo que pasaba entre las dos raices del nervio mediano. Los casos con este tipo de variaciones deben ser examinados u operados cuidadosamente durante prodecimientos quirurgicos o electro fisiologicos

A rare case of additional slip in the origin of the clavicular head of sternocleidomastoid muscle was found during our routine dissection, on both sides of the neck in an elderly male cadaver. However, on both side of the same muscle no such additional slip of origin was found at the sternal head of the sternocleidomastoid near its origin nor at its insertion of the muscle Durante una disección de rutina, fue encontrado un raro caso de un fascículo adicional en el origen de la cabeza clavicular del músculo esternocleidomastoideo, en ambos lados del cuello, en un cadáver de un anciano de sexo masculino. Sin embargo, en ambos lados, no se encontró un fascículo adicional en el origen de la cabeza esternal ni en la inserción del músculo esternocleidomastoideo

Durante una diseccion de rutina, fue encontrado un raro caso de un fasciculo adicional en el origen de la cabeza clavicular del musculo esternocleidomastoideo, en ambos lados del cuello, en un cadaver de un anciano de sexo masculino. Sin embargo, en ambos lados, no se encontro un fasciculo adicional en el origen de la cabeza esternal ni en la insercion del musculo esternocleidomastoideo