DFT Study on the Spin States of Polyaniline-3d Transition-Metal (Sc-Zn) Composites and Their Sensing Application to Detect Chemical Warfare Agents.

Organic-inorganic composite materials, combining polymers with transition metal (TM) atoms based on PAni and 3d TMs, have been designed and investigated in various spin states by performing density functional calculations. These designed composites were analyzed for their stability in different spin states as well as for their calculated electronic properties, including binding energies, frontier molecular orbitals, and dipole moments. Additionally, 3D isosurfaces and 2D scattered plots of reduced density gradient as a function of (sign λ2)ρ provide insights into the noncovalent interactions between the composite units. The most stable Mn@PAni composite has been assessed as a sensing material for chemical warfare blood agents (HCN, NCCl, NCBr, NCCN, and AsH3) using density functional-based calculations. The reduced band gap and significant red/blue shift in the UV-vis spectra obtained through TDDFT calculations underline the selectivity and efficiency of the Mn@PAni composite toward different analytes.

Posterior Leaflet of Mitral Valve-Is it Really Tri-scalloped? -A Morphological and Morphometric Study in North Indian Cadaveric Hearts.

Background: Maintaining normal left ventricular geometry and function depends on the mitral valve's normal integrity. Irreparable damage to the mitral valve calls for its replacement using either a valve made up of biological tissue or metal, pyrolytic carbon, and similar materials. Materials and Methods: The material consists of 50 formalin-fixed adults, seemingly normal cadaveric hearts of either sex which were received from the Department of Anatomy of various institutes in the north region. These hearts were cut open to access the mitral valve in the left ventricle. Results: In this study, the posterior leaflet was semi-oval in shape being 3.72 cm wide at the base. Usually said to be tri-scalloped, interestingly, it was found so only in 56% of the hearts; being bi-scalloped in 20% and single-cusped in 16% of the hearts. Even four scallops and six scallops were observed in three (6%) and one (2%) hearts, respectively. Conclusions: To conclude, notable variation has been seen in the scallops of posterolateral cusps in the present study. The number of scallops varies greatly as single, double, three, four, or tetra-scalloped and most significant six or hexa-scalloped which has never been reported in the previous studies. To understand the rationale behind each unique architectural layout, such noticeable variations are crucial for scientists around the world. Cardiothoracic surgeons could find this information valuable for mitral valve surgery repair.

A rare metastatic mesenteric malignant PEComa with TSC2 mutation treated with palliative surgical resection and nab-sirolimus: a case report.

BACKGROUND: Malignant perivascular epithelioid cell tumors (PEComas) are exceedingly rare malignant mesenchymal neoplasms with characteristic morphological and immunohistochemical (IHC) patterns. However, some malignant PEComas are poorly differentiated with atypical histopathological features, making a definitive diagnosis difficult. PEComas are most commonly found in females and often show either TSC1 or TSC2 alterations, which result in the activation of the mTOR pathway, or TFE3 fusions. Given these molecular characteristics, mTOR inhibitors have recently been approved by the FDA in the treatment of malignant PEComas, particularly in those with TSC1/2 alterations. Therefore, molecular analyses may be helpful for both the diagnostic workup of and predicting response to mTOR inhibitors in cases of malignant PEComas. CASE PRESENTATION: Here, we report a case of an aggressive, 23 cm mesenteric malignant PEComa with multiple peritoneal metastases in a young male patient. Pathological examination of the initial biopsy showed a malignant epithelioid neoplasm with high-grade morphology and atypical immunoprofile, which precluded a definitive diagnosis. Because of the patient's excessive transfusion requirements due to intra-tumoral hemorrhage, a palliative R2 resection was performed. Histopathological examination of the tumor revealed focal immunoreactivity for Melan-A, HMB-45, desmin, and CD117. Although a diagnosis of malignant PEComa was favored, other entities such as epithelioid gastrointestinal stromal tumor (GIST) or melanoma could not be definitively ruled out. Given the favored diagnosis, the patient was started on sirolimus, an mTOR inhibitor, rather than chemotherapy. Molecular analyses were performed and the tumor was found to harbor mutations in TP53 and TSC2, supporting a definitive diagnosis of malignant PEComa. The patient was then switched to nab-sirolimus, with initial stabilization of the disease. CONCLUSIONS: This report details a multidisciplinary approach for the diagnosis and management of a highly aggressive, metastatic malignant PEComa in a young male patient. The basis for the treatment of malignant PEComas with the recently FDA-approved mTOR inhibitor, nab-sirolimus, is also reviewed. In summary, this case highlights the importance of molecular analysis, particularly TSC1/2 alterations, for both the definitive diagnosis of malignant PEComas and predicting their response to nab-sirolimus.

A four trunked brachial plexus and a post fixed brachial plexus: a conjunction or a co-incidence? Report of three cases.

The anatomical variations of the brachial plexus in humans have clinical significance for surgeons, radiologists, and anatomists. In a study of 60 brachial plexuses, four trunked brachial plexuses were encountered in three limbs (two female and one male), all of them being post fixed and on left side of cadavers. The third trunk in all these limbs gave rise to two anterior divisions (upper and lower) and one posterior division. In two limbs belonging to the female sex, the upper anterior division joined with the anterior division of the second trunk to form the lateral cord while its lower anterior division joined with the anterior division of the fourth trunk to form the medial cord. In the sole male limb, along with the third trunk, the fourth trunk also divided into upper and lower anterior divisions. Upper anterior divisions of the third and fourth trunks joined to form the medial root of the median nerve while lower anterior divisions joined to form the ulnar nerve. No medial cord was formed as such. Further, it is inferred that in postfixed brachial plexus, there is a tendency to failure on part of T1 and T2 to join C8 which continues as the third trunk while T1 and T2 continue as the fourth trunk. Since it was seen in all postfixed brachial plexuses of the present study, it is emphasized to be given a place in the textbooks of anatomy or to conduct a study on a larger database.

Localization of mandibular foramen - a comparison between dry bones and orthopantomogram.

An inferior alveolar nerve block is a usual practice by a dental practitioner. Panoramic radiography is a widely used technique in dentistry to get a clear and comprehensive view before planning any treatment. The study aimed to compare the morphometric localization of mandibular foramen (MF) on dry bones and orthopantomogram. The study was designed in two phases: a morphometric study on dry human mandibles (phase I) and orthopantomograms of the same dry human mandibles (phase II). The study materials were 200 dry north Indian human mandibles belonging to unknown sex obtained from the Department of Anatomy. Descriptive statistics, including range, mean±standard deviation, paired t-test to compare dry bones and orthopantomogram, Pearson's correlation coefficient, and measurement error, were used. T-test was applied separately to compare the right and left sides of dry bones. The distance of mandibular foramen from the posterior border and lower border is shorter on the right side than on the left. Its distance from the anterior border and the mandibular notch was greater on the right side. On panoramic radiographs, the distance of MF from nearby anatomical landmarks on the mandible was highly unreliable except for the mandibular notch. Our findings demonstrate a statistically significant difference between distances on dry bone and OPG but no statistically significant difference between MF-notch on both sides and MF-AB on the right side. As a result, a surgeon can rely upon a mandibular notch to locate mandibular foramen during clinical procedures. Magnification is an inbuilt property of OPG; for precise localization of MF, it is advisable to proceed with advanced three-dimensional techniques to protect viable anatomical structures.

Intratemporal Facial Nerve Anatomy and its Variations in 30 Cases of Cadaveric Temporal Bones.

It is important for the ENT surgeon to be familiar with the anatomy of the facial nerve and to prevent iatrogenic injury to nerve as it shows variations in its intratemporal course. Present study was done to delineate the intratemporal course of facial nerve and observe its variations. Thirty wet cadaveric temporal bones were dissected in the temporal bone dissection laboratory in the Department of Otorhinolaryngology and Head Neck Surgery, Government Medical College, Patiala. The length of intratemporal segments of facial nerve, its relationship with important bony landmarks, and the presence of any anomaly or variations in its course were observed. The mean length of labyrinthine, tympanic and mastoid segment was found to be 4.28 ± 0.605 mm, 10.40 ± 1.416 mm and 12.34 ± 0.915 mm respectively in the dissected specimens. The first and second genu angle varied between 50°-90° and 90°-120° respectively. Facial canal dehiscence was present at the level of first genu in 10% of cases and at the level of tympanic segment in 33%. Distance between chorda tympani origin and stylomastoid foramen varied between 4 and 6 mm with mean value of 5.31 ± 0.603 mm. Chorda-facial angle was found to be in the range of 20° to 31° with mean of 25.30° ± 2.90°. The tympanomastoid segment of facial nerve has variations in length and in its relations with various middle ear structures. The facial canal, as it traverses the temporal bone, may display bony dehiscence, variations, and anomalies in its natural course, having its own clinical and surgical significance.

The role of the anterior border of the hip bone in sexual dimorphism: a morphometric study in the North Indian population.

Understanding sexual dimorphism is very important in studies of human evolution and skeletal biology. The ability to determine sex from unknown skeletal remains is vital and methods to do this on the various bones of the human skeleton have been researched extensively especially in the studies related to forensic anthropology. The distinctive morphology and clear sexual dimorphism of the hip bone makes it an ideal bone for sex determination. Whereas the roles of the parameters of its posterior border (including the greater sciatic notch) are well established, those of the anterior border are not much explored. The present study was designed to establish the morphometric pattern of the anterior border of the hip bone and its role in sexual dimorphism. Material for the current investigation comprised 100 hip bones belonging to 50 cadavers ([M:F = 80:20] and [R:L = 50:50]) obtained from the Department of Anatomy, Government Medical College, Amritsar, Punjab, India. Sixteen parameters of the anterior border were taken and three indices were calculated. Eight parameters were significantly greater in males: (i) straight distance anterior superior iliac spine (ASIS)-symphyseal surface (SS); (ii) straight distance ASIS-pubic tubercle (PT); (iii) straight distance anterior inferior iliac spine (AIIS)-SS; (iv) straight distance AIIS-PT; (v) arch of anterior interspinous notch (ASIS-AIIS); (vi) arch between AIIS and ilio-pubic (IP); (vii) depth of notch between AIIS and IP; (viii) arch of anterior border (ASIS-SS). The results of the present study could be helpful in pronouncing an opinion, for a single specimen, about its origin in general terms or sex.

Morphological and Morphometric Analysis of the Orbital Aperture and Their Correlation With Age and Gender: A Retrospective Digital Radiographic Study.

Purpose Precise knowledge about clinically observed bony orbital aging is needed for surgical planning for acceptable cosmetic results. The effect of age and gender on the facial skeleton and orbital aperture has been appreciated earlier, but its quantification remains ignored. The purpose of this study was to evaluate age- and sex-related changes in the shape of the orbital aperture and construct a reference data set for the aging phenomenon in Indians. Methods Two hundred digital radiographs (Water's/frontal view) of the skull, obtained for various reasons, were evaluated. The radiographs comprised 107 males and 93 females aged between 10 and 60 years (10-59 years). Orbital shape, height/width, and interorbital/biorbital distances were noted, and orbital indices (OIs) were calculated. Orbital parameters thus obtained were compared between right and left sides and males and females. The relation of the parameters with age and gender was analyzed. Results Four types of orbits, round (33.5%), elliptical (30.5%), rectangular (27.5%), and square (9.5%), were noted in the study population. The average value of height and width of the right orbit was found to be higher than that of the left (p > 0.05). Male patients had higher (p > 0.05) and wider (p > 0.05) orbits than females. The right OI (81.55 ± 5.30) was higher than the left (80.75 ± 4.80) (p > 0.05). When comparatively evaluated between gender, both orbits were found to be of the microseme type with a mere difference (p > 0.05). The average interorbital/biorbital distance was 1.27 ± 2.11 and 9.78 ± 4.40 cm, respectively, without any gender difference. No significant relation was found between the age change and the parameters defined (p > 0.05), except in one age group (10-19 years). Conclusions Orbital dimensions showed no association with age and gender except in one age group (10-19 years); a pubertal growth spurt in females might be causing this phenomenon. The morphometric data may be useful in forensic anthropology and better planning for reconstructive surgeries in the orbito-maxillary region.

Morphometric Analysis of the Corpus Callosum Using Cadaveric Brain: An Anatomical Study.

PURPOSE: The present study was conducted to measure the longitudinal and vertical lengths of the brain hemisphere, longitudinal length of the corpus callosum (CC), and distances of CC from the frontal and occipital poles, in order to define its topographic location within the brain hemispheres. MATERIALS AND METHODS: Fifty formalin-fixed human brains were dissected in the midsagittal plane. The parameters measured were as follows: (i) straight distance between frontal and occipital pole (AB); (ii) vertical distance (height) between the upper and lower surface of the brain hemisphere (CD); (iii) frontal pole to anterior-most point of CC (EG); (iv) occipital pole to posterior-most point of CC (ZO); (v) anterior-most point to posterior-most point of CC (EZ); and (v) anterior edge of genu to the upper end of lamina terminalis (EF). RESULTS: The mean value of AB, CD, EG, ZO, EZ, and EF was 15.47 ± 0.94 cm, 9.48 ± 0.83 cm, 3.31 ± 0.29 cm, 5.65 ± 0.54 cm, 6.96 ± 0.55 cm, and 2.1 ± 0.39 cm, respectively. AB had the strongest positive correlation with ZO (0.79), whereas CD (height) had it with EZ (0.59). Both AB and CD had a strong positive correlation with EZ. The ratios EZ/AB = 0.45 (P = 0.001) and EZ/CD = 0.73 (P = 0.003) illustrated a steady and significant proportions, present in all the brains studied. Although the mean values of all the parameters were greater in males than in females, only two parameters (ZO and EZ) showed statistically significant (P < 0.05) gender differences. CONCLUSION: The precise anatomical knowledge regarding the morphometry of CC will provide baseline data for the diagnosis and progression of disease affecting it.

Re-definition of position and calculation of safe area for axillary nerve in deltoid muscle with its clinical relevance: a cadaveric study.

Several authors have made efforts to define the position of the axillary nerve within deltoid muscle and to calculate the so called safe area for this nerve but it still remains a matter of debate. The primary aim of the study was to investigate the acromio-axillary (AA) distance and its correlation with upper arm length. The secondary aim was to re-define the safe area for axillary nerve within deltoid muscle. Sixty shoulders of thirty adult human cadavers were dissected using standard methods. The distance from the anterior and posterior edge of acromion to the upper border of the course of the axillary nerve was measured and recorded as anterior and posterior AA distance respectively. Correlation analysis was done between the upper arm length and AA distance for each limb. The ratios between anterior and posterior AA distance and upper arm length were calculated and mentioned as anterior index and posterior index, respectively. The mean of anterior and posterior AA distance was 5.22 cm and 4.17 cm, respectively. The mean of upper arm length was 29.30 cm. The means of anterior index and posterior indices were 0.18 and 0.14, respectively. There was a significant correlation between upper arm length and both the anterior and posterior AA distance. The axillary nerve was found to lie at variable distance from the acromion. The minimum AA distance was found to be 3.50 cm. So this should be considered as the maximum permissible length of the deltoid split. Upper arm length has strong correlation with both anterior and posterior AA distances. The ideal safe area for the axillary nerve was found to be a quadrangular area above it and the size of which depends on the length of the upper arm.

Accessory soleus muscle in clubfoot deformity: a report in four feet.

The commonest presentation of accessory soleus muscle is a swelling at the posteromedial aspect of the ankle in adolescents or young adults. Accessory soleus is rarely encountered in children undergoing surgical release for congenital clubfoot, and only a few isolated reports are available in the literature. The purpose of this study is to heighten awareness about the role of accessory soleus muscle in clubfoot deformity. Four cases of accessory soleus muscle in patients undergoing surgical release for clubfoot deformity are reported here in which, a distinct anomalous muscle deep to the tendoachilles was identified. Hindfoot varus and equinus persisted in each of these cases despite an adequate posteromedial soft tissue release, which could be corrected only on tenotomizing the tendon of the accessory soleus muscle at its insertion. An awareness about the accessory soleus muscle is important, particularly when non-operative methods of clubfoot management with tendoachilles tenotomy or limited surgery are employed. Failure to recognize this muscle if present in patients with congenital clubfoot may lead to persistent hindfoot deformity. A high index of suspicion should be maintained in cases in which hindfoot deformity persists despite an otherwise adequate soft tissue correction.

Morphological and Morphometric Study of Coronary Sinus in North Indian Population.

INTRODUCTION: Coronary sinus (CS) is the largest vein draining the blood from heart. It is a muscular tube of about 2 cm to 3 cm length and 1 cm in caliber. It has become a clinically important structure through its role in providing access for different cardiac procedures viz., biventricular pacing, arrhythmia ablation and for deployment of an array of cardiac devices. AIM: To study the location, shape, length and width of CS including its left atrial muscular coverage in 50 cadaveric hearts. MATERIALS AND METHODS: The present study comprised of 50 adult human apparently normal formalin fixed cadaveric hearts belonging to either sex obtained from the Department of Anatomy, Government Medical College, Amritsar, India. Location and shape of CS were noted, external and internal lengths of the CS were measured with the help of a thread and Vernier caliper. Width of CS was measured at three levels; at the beginning, at the point of entry of Middle Cardiac Vein (MCV) and at termination in right atrium. The walls of CS were examined to note whether they were covered by the muscles of left atrium or not. Descriptive analysis was done to calculate range, mean and Standard Deviation (SD) by using Statistical Package for Social Science (SPSS) 17.0. RESULTS: CS was located in the posterior atrioventricular sulcus in 98%. Two shapes; funnel in 82% and tubular/cylindrical in 18% were observed. External length of coronary sinus ranged from 20.5 mm to 58.78 mm (mean 38.22±8.6 mm) and internal length ranged from 16.28 mm to 49.6 mm (mean 34.48±8.9 mm). Maximum width of coronary sinus was at its termination (9.61±2.6 mm) and it was covered by muscles of left atrium in 96% of hearts. CONCLUSION: CS is a constant structure in cardiac venous anatomy but its location, shape, length and width are variable. Knowing these variations can help cardiac surgeons especially during cardiac resynchronization therapy, ablation and defibrillation.

Cadaveric Study of Berretini Communications in North Indian Population.

INTRODUCTION: Intercommunication between peripheral nerves deserves special attention in view of their clinical significance. Superficial palmar communication between the median nerve and ulnar nerve is referred to as Berrettini Anastomosis. The presence or absence of this communicating branch varies between individuals. Earlier, incidence of Berretini communication reported varied significantly (4-94%). AIM: The aim of this study was to find out the frequency with which Berretini communication is found in North Indians. MATERIALS AND METHODS: The present study was conducted on 60 upper limbs of 30 cadavers at the Government Medical College, Amritsar. The whole course of the median nerve and the ulnar nerve was exposed. Communicating rami in the hand were identified, cleaned and photographed. RESULTS: In all the six (10%) variant limbs, the communicating branch originated from lateral common palmar digital branch of ulnar nerve and joined medial common palmar digital branch of median nerve. Single communication with oblique course was seen in all the variants. Further, its ontogeny and clinical implications have been discussed in detail. CONCLUSION: The Berretini anastomosis was seen in 10% upper limbs of the present study. Damage to the communicating branch or the severing of the branch might result in sensory loss which may be difficult to diagnose owing to the large number of variations in the origin of the communicating branch. The patterns of sensory impairment may vary depending upon the branch of median and ulnar nerve it is seen connecting.

Martin-Gruber Anastomosis- A Cadaveric Study in North Indian Population.

INTRODUCTION: Communications between peripheral nerves are important in the light of the fact that these are responsible for a myriad of clinical symptoms. Communication between the median nerve and ulnar nerve (Martin-Gruber anastomosis) is a frequent finding observed anatomically in 10%-30.6% subjects and physiologically in 5-40%. It may lead to exacerbated or attenuated clinical symptoms. AIMS & OBJECTIVES: To find out the incidence of Martin-Gruber anastomosis in North Indian population by cadaveric dissection. MATERIALS AND METHODS: The material comprised of 60 upper limbs belonging to 30 cadavers (M:F::28:2) which were dissected to find out incidence of Martin-Gruber anastomosis. RESULTS: Martin-Gruber anastomosis was encountered in 7(11.6%) limbs of the present study. It was seen more frequently unilaterally (16.6%) than bilaterally (3.3%) and only in males. Classification of limbs into various patterns and types was done. Further its ontogeny, phylogeny, genetic inheritance and clinical implications are discussed in detail. CONCLUSION: To conclude, in North Indian population, the Martin-Gruber anastomosis is encountered in 11.6% limbs.

An unusual 'w' shaped thyroid gland with absence of isthmus - a case report.

Thyroid gland is one of the largest endocrine glands located in the neck opposite C5-T1 vertebrae. It consists of 2 lobes connected to each other by an isthmus. It depicts a number of congenital anomalies. One such variant was seen in a 55-year-old male cadaver whereby the gland was 'W' shaped in toto with each lobe consisting of medial & lateral limbs. The medial limbs of the 2 lobes united with each other in the midline in the form of an inverted '^' and thus the gland was 'W' shaped. The isthmus as such was absent. It is an extremely rare condition which should be known to the surgeons operating in this area. Its ontogeny, phylogeny & clinical/surgical implications are discussed in detail.

Morphometric analysis of upper end of tibia.

INTRODUCTION: The present study aims to assess different morphometric parameters of condylar and intercondylar surface of tibia and to compile the results, analyze and formulate a baseline data for future studies with relevance to Indian population and also to compare the current data with accessible literature for pertinent surgical utilities. Morphometric parameters of upper end of tibia can be used to guide treatment and monitor outcome of total knee replacement surgeries. Information regarding morphometry of upper end of the tibia is vital as it provides reliable method of assessing knee deformity. MATERIALS AND METHODS: The study group comprised of 50 male and 50 female adult human tibiae. Morphometric measurements of medial condyle, lateral condyle and intercondylar area of tibiae were meticulously recorded with digital Vernier calipers with a least count of 0.01 mm. Student's t-test was used with significant level of p-value < 0.05 and 95% confidence interval. RESULTS: All measurements were found to be statistically significant when compared between the two sexes on both sides (p-value<0.05). Anteroposterior measurements were found to be greater than transverse measurements for both medial and lateral condyles. Furthermore, both anteroposterior and transverse measurements were greater in medial condyle than in lateral condyle on both sides and sexes. CONCLUSION: The present study is an endeavor to provide a base line data pertaining to morphometric details of upper end of tibia with reference to unicompartmental and total knee arthroplasty in Indian population. The results of the study assume special importance in view of the technical advancements in reconstructive surgical procedures in orthopedic practice.

Human tibial torsion--morphometric assessment and clinical relevance.

BACKGROUND: Tibial torsion is an important anatomical parameter in clinical practice and displays variability among individuals. These variations are extremely significant in view of alignment guides such as those related to rotational landmarks of tibia in total knee arthroplasty. Further, precise knowledge and information pertaining to angle of tibial torsion also helps in correction of traumatic malunion or congenital maltorsion of tibia. METHODS: The present study was carried out to determine the angle of tibial torsion in 100 adult dry tibia bones in the Department of Anatomy, Government Medical College, Amritsar. The study group comprised 50 males and 50 females with equal number of right- and left-sided bones. The measurements were meticulously recorded and the data were subjected to statistical analysis. The results were analyzed and discussed in the light of existing literature. RESULTS: On the right side, it was found to be 29.84° ± 4.86°° (range = 22.00° -38.00°) in males and 28.92° ± 5.10°° (range = 15.00°-38.00°) in females. On the left side, it was found to be 28.00° ± 4.94°° (range = 20.00°-40.00°°) in males and 28.12° ± 4.28°° (range = 20.00°-37.00°°) in females. CONCLUSION: The present study is an endeavor to provide baseline data with reference to the angle of tibial torsion in the Indian population. The results of the study assume special importance in view of the technical advancements in reconstructive surgical procedures in orthopedic practice.

Multiple musculovascular anomalies in the superior extremities of a cadaver: a case report.

During the evolution from the lower animals to man, the upper limbs have acquired a great mobility, but at the cost of their stability. The reverse is true for the lower limbs. The muscular anomalies which are common in the upper limbs are largely explainable on a phylogenetic basis. The same is true for the vascular anomalies. However, such anomalies are usually seen singly and they are never together in the same limb or in two limbs of the same body. The upper limbs which are being reported here had multiple musculovascular anomalies and some of these were bilateral. These include the superficial brachial artery, the accessory head of the biceps brachii, the accessory muscular slips which arose from the common flexor origin and went to the tendons of the flexor digitorum profundus and the flexor pollicis longus separately, bifurcation of the tendon of insertion of the brachioradialis and bifurcated (split) insertion of the third lumbrical on the adjacent fingers. Though all these variations have been described in the standard text books of Anatomy, their occurrence, together in one limb and the bilateral presentations of some of these, have never been encountered. Almost all these variations have been explained phylogenically, thus supporting the dictum, "The ontogeny repeats the phylogeny." Furthermore, their clinical significance has also been discussed.

A two trunked brachial plexus: a case report.

The brachial plexus is a major and a complicated plexus at the root of the neck. It is formed by the ventral primary rami of the C5, C6, C7, C8 and the T1 spinal nerves. During the routine under graduate dissection of the right upper limb of an adult female cadaver, a variant pattern of a two trunked brachial plexus was encountered. The upper trunk was formed by the fusion of the C5 and the C6 roots. The C7 root, instead of continuing as the middle trunk, joined with the roots of C8 and T1 to form the lower trunk. On the left side, the usual pattern of the brachial plexus was seen. The knowledge on such variations are of interest to anatomists, clinicians, anesthesiologists and especially, to surgeons. These are of immense importance during surgical explorations of the axilla and the arm region and also during nerve blocks. It also helps the clinicians in getting a proper understanding of some previously unexplained clinical symptoms. Further, the ontogeny and the phylogeny of this entity have been discussed in detail.

A cadaveric study of different angles of scapula and their role in kinesiometrics and muscle morphology.

INTRODUCTION: The bipedal gait and consequential freedom of the upper limb in human beings has made the movements of the shoulder joint a subject of extensive investigations. The scapular angles provide the base and leverage to various muscles and have been correlated with the different movements of the shoulder joint. METHODS: In the present study, different angles of scapula namely superior, inferior, lateral, medial, acromial and coracoid angles were measured in the North Indian population. The study was conducted on 100 scapulas (R:L=50:50) obtained from Department of Anatomy, Government Medical College, Amritsar. For measuring the angles, centimetre scales and protractor were used. RESULTS: The mean value of superior angle was observed to be 100.830 (R=100.320 : L=101.340); inferior angle was 63.620 (R=68.10:L=59.140); lateral angle was 61.720 (R=65.90 : L=57.540); medial angle was 147.640 (R=151.320 : L=143.960); acromial angle was 106.470 (R=107.680 : L=105.260) and coracoid angle was 83.30 (R=84.240:L=82.020). CONCLUSIONS: It was observed that all angles were higher in the right sided bones except superior angle. Also a wide range was seen in all the angles.