Anatomical landmarks for localisation of the anterior ethmoidal artery: a combined radiological and cadaveric (endoscopic) study.

PURPOSE: The anterior ethmoidal artery is a major surgical landmark that is susceptible to iatrogenic injury during surgery of the anterior ethmoidal sinus, frontal sinus, and skull base. The present study aimed to define the location of the anterior ethmoidal artery in relation to specific anatomical landmarks using radiological imaging and endoscopic dissection. METHODS: Eighty-six anterior ethmoidal arteries were assessed using computed tomography scans (bilateral analyses) and forty anterior ethmoidal arteries were assessed using cadaveric specimens (bilateral analyses). The skull base, anterior nasal spine, anterior axilla of the middle turbinate, and nasal axilla were morphometrically analysed to determine their reliability as anterior ethmoidal artery landmarks. RESULTS: Distances to the skull base, anterior nasal spine, and nasal axilla displayed statistically significant differences between sexes and sides (p < 0.05). All landmarks demonstrated excellent reliability as anatomical landmarks for the localisation of the anterior ethmoidal artery, radiologically and endoscopically (ICC values ranged from 0.94 to 0.99). CONCLUSION: The middle turbinate axilla was the most reliable landmark, due to the lack of statistically significant differences according to sex and laterality, and the high inter-rater agreement between measurements. Anatomical knowledge of variations and relationships observed in the present study can be applied to surgeries of the anterior ethmoidal sinus, frontal sinus, and skull base to improve localisation of the anterior ethmoidal artery, preoperatively and intraoperatively, and avoid iatrogenic injury of the vessel.

Studies on testicular ultrastructural and hormonal changes in type-2 diabetic rats treated with highly active antiretroviral therapy conjugated silver nanoparticles.

AIM: This study investigated the impact of highly active antiretroviral therapy (HAART) loaded silver nanoparticles (AgNPs) as HAART-AgNPs on the sperm count, viability, serum hormonal profile, insulin-like growth factor I (IGF-1), and testicular ultrastructure. METHODS: Thirty-six adult male Sprague-Dawley rats were allocated into diabetic and non-diabetic groups (n = 18). The rats in the diabetic group were induced experimental type 2 diabetes using fructose and streptozotocin (frt-STZ). Animals in both groups were subdivided into three groups each, A-C and DF (n = 6), and received distilled water, HAART, and HAART-AgNP, respectively. FINDINGS: Treatment with HAART-AgNP displayed a significant increase (p < 0.05) in serum gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testicular IGF-1 in diabetic rats. Also, electron microscopy revealed ameliorated testicular ultrastructure upon administration of HAART-AgNP in diabetic rats that were previously marked with architectural and cellular alterations. In addition, treatment with HAART-AgNP significantly reduced (p < 0.05) the blood glucose levels of diabetic rats. In contrast, the treatment of non-diabetic rats with HAART caused a significant decrease (p < 0.05) in the sperm count, serum GnRH, and testicular IGF-1, however, this treatment induced ultrastructural changes and a significant increase (p < 0.05) in serum testosterone levels in diabetic and non-diabetic rats. SIGNIFICANCE: This study has demonstrated the beneficial impact of HAART-AgNP on the hypothalamic-pituitary-gonadal axis, IGF-1, and testicular architecture in male frt-STZ induced diabetic rats. This nanoconjugate could be a potential nano-drug candidate to cater for testicular dysfunction and metabolic derangements while managing HIV-infected male individuals.

Developmental changes of the facial skeleton from birth to 18 years within a South African cohort (A computed tomography study).

Skeletal remains are often found on a crime scene in which a forensic anthropologist is then consulted to create a biological profile, which includes the estimation of age, sex, ancestry and stature. The viscerocranium plays an important role in the formation of a biological profile. However, to utilise the viscerocranium for age estimation, population specific normative data and knowledge of the development of the viscerocranium is required. Therefore, this study aimed to investigate the developmental changes from birth to 18 years of age of the facial skeleton of individuals from a South African cohort. This study comprised of 239 computed tomography (CT) scans (128 males; 111 females). The viscerocranium was subdivided into five regions viz.: orbital, nasal, midfacial, maxillary and mandibular. The linear parameters in each region were correlated to age to identify the developmental growth patterns of the viscerocranial regions according to male and female. The measurements which displayed the highest correlations with age were used to develop formulas which could be used for age estimation. The results of this study showed that the measurements in the orbital, midfacial, maxillary and mandibular regions experienced rapid growth between 0 and 5 years of age, with the nasal region increasing steadily over time. It was noted that males displayed overall larger measurements than females except for the anterior interorbital distance and both right and left zygomatic arch lengths (ZAL). Although only the left orbital height, nasal aperture height and mandible width displayed statistically significant size differences according to sex (p ≤ 0.05). The measurements which showed the highest correlations to age were the zygomatic arch distance (r = 0.8842, p < 0.001), ZAL (right: r = 0.8929, p < 0.001; left: r = 0.8656, p < 0.001) and the mandible width (r = 0.8444, p < 0.001). Formulas were derived for the measurements that could be used to forensically estimate age within a subadult cohort.

Novel severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection: Microbiologic perspectives and anatomic considerations for sanctuary sites.

INTRODUCTION: A significant chunk of global life - the economy, sports, aviation, academic, and entertainment activities - has significantly been affected by the ravaging outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) with devastating consequences on morbidity and mortality in many countries of the world. METHODS: This review utilized search engines such as google scholar, PubMed, ResearchGate, and web of science to retrieve articles and information using keywords like "Coronavirus", "SARS-CoV-2", "COVID-19", "Origin of coronavirus and SARS-CoV-2", "microbiology of coronavirus", "microbiology of SARS-CoV-2", COVID-19", "Coronavirus reservoir sites", "Anatomic sanctuary sites and SARS-CoV-2", biological barriers and coronavirus", biological barrier and SARS-CoV-2". RESULTS: While this pandemic has caught the global scientific community at its lowest level of preparedness, it has inadvertently created a unified and wholesome approach towards developing potential vaccine (s) candidates by escalating clinical trial protocols in many countries of Europe, China and the United States. Interestingly, viral pathobiology continues to be an evolving aspect that potentially shows that the management of the current outbreak may largely depend on the discovery of a vaccine as the administration of known antiviral drugs are proving to offer some respite. Unfortunately, discontinuation and longtime administration of these drugs have been implicated in endocrine, reproductive and neurological disorders owing to the development of pathological lesions at anatomical sanctuary sites such as the brain and testis, as well as the presence of complex biological barriers that permit the entry of viruses but selective to the entrance of chemical substances and drugs. CONCLUSION: This review focuses on the microbiologic perspectives and importance of anatomical sanctuary sites in the possible viral rebound or reinfection into the system and their implications in viral re-entry and development of reproductive and neurological disorders in COVID-19 patients.

The septation of the sphenoidal air sinus: a cadaveric study / Septación del seno esfenoidal: investigación cadavérica

The purpose of this study was to investigate the sphenoidal sinus septation in a select South African population, and document the relation of the number and location of the septa to the structures intimately related to the sinus. The intersinus and intrasinus septa of the sinus, the number and attachments of the septa were recorded from forty five cadaveric head specimens. The sphenoidal sinus intersinus septa were recorded as follows: Type 0 (absent septum) in 7.5 %, Type 1 (single septum) in 65 % and Type 2 (double septa) in 22.5 % of cases. The incidence of intersinus septa deviating to the left was prevalent; hence, the right sphenoidal sinus was dominant. The occurrence of intrasinus septa was observed in 93.3 % of cases, with a higher prevalence in males. The intrasinus septa formed cave like chambers on the sinus walls in 65.6 % cases. Incidences of the intersinus septa attaching to sella turcica (ST) (46.25 %) were prevalent compared to cases where they attached to the internal carotid artery (ICA) (6.25 %), maxillary (MN) (1.25 %) and vidian (VN) (1.25 %) nerves. However, the intrasinus septa attached more to the ICA (52.63 %) compared to their attachment to the other neurovascular structures (ST - 26.32 %; MN - 5.36 % and VN - 2.63 %). Surgeons need to be aware of the complex anatomical variations of the sphenoidal sinus septation when performing endoscopic endonasal transsphenoidal surgeries.

El propósito de este estudio fue investigar la septación del seno esfenoidal en una población sudafricana y documentar la relación del número y la ubicación de los septos en relación a las estructuras íntimamente relacionadas con el seno. Los septos interseno e intraseno del seno, el número y las uniones de los septos se registraron a partir de cuarenta y cinco cadáveres. El septo interseno del seno esfenoidal se registró de la siguiente manera: Tipo 0 (tabique/septo ausente) en el 7,5 %, Tipo 1 (tabique/septo único) en el 65 % y Tipo 2 (tabiques/septos dobles) en el 22,5 % de los casos. La incidencia de septos intersenos desviados hacia la izquierda fue prevalente. Por lo tanto, el seno esfenoidal derecho fue dominante. La ocurrencia de septo intraseno se observó en el 93,3 % de los casos, con una mayor prevalencia en varones. Los septos intrasenos formaron cámaras, como cuevas, en las paredes del seno en un 65,6 % de los casos. La incidencia de septos intersenos que se adhieren a la silla turca (ST) (46,25 %) fueron prevalentes en comparación con los casos en que se unieron a la arteria carótida interna (ACI) (6,25 %), al nervio maxilar (NM) (1,25 %) y nervio vidiano (NV) (1.25%). Sin embargo, los septos intersenos se adhirieron más a la ACI (52,63 %) en comparación con su unión a otras estructuras neurovasculares (ST - 26,32 %; NM -5,36 % y NV - 2,63 %). Los cirujanos deben ser conscientes de las complejas variaciones anatómicas de la tabicación del seno esfenoidal cuando se realizan cirugías transesfenoideas endonasales endoscópicas.