The Usefulness of Cadaveric Hands-on Workshop for Surgical Training in Head and Neck Surgeries.

Surgical approach to head and neck region requires in depth anatomical knowledge and refined surgical skills due to highly critical and complex anatomy of this region. To look for the benefit of cadaveric hands-on workshop on enhancing the surgical knowledge and confidence of the participants. Freshly frozen cadavers were used for this hands-on course in the department of Anatomy, AIIMS Raipur involving 32 residents and ENT specialists. This course involved the interactive lectures and live surgical demonstration on issues related to neck dissection, thyroid, and parotid surgery followed by a hands-on practice by the residents. A positive feedback was given by the participants in regards to the cadaveric hands-on workshop. Almost 4/5th of the participants found the present experience to be extremely helpful and all of them believed the cadaveric hands-on workshops should be conducted regularly as a learning tool and enhancement of surgical skills. Cadaveric hands-on dissection is a very effective practice for refining surgical skills. It can be used to study basic surgical procedures or extremely complex surgeries having intricate anatomy. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-04182-6.

Comprehensive Study of Arrangement of Renal Hilar Structures and Branching Pattern of Segmental Renal Arteries: An Anatomical Study.

Background The knowledge of renal artery (RA) and its segmentation is critical before attempting any surgical procedure of kidney. The RA receives blood supply from various arteries during its descent in the embryonic period. As a result, the segmental RAs show a lot of variability in the site and pattern of origin as well as its point of entry in the kidney. Aim/objective The aim is to study the variable pattern existing in different segmental RAs and the arrangement of structures at the renal hilum. Methods The RA of 205 kidneys (68 paired and 69 unpaired) was studied and the segmental pattern was exclusively observed in cadavers by dissecting 161 kidneys, making resin/silicon casts of 34 kidneys and radiological imaging of 10 kidneys. Results The results obtained were quite significant and provided in detail understanding of the five main segmental arteries and the arrangement of structures at the renal hilum. Great variations were seen in the disposition of structures at the renal hilum. Six different patterns of structures at the renal hilum were obtained. Pattern 1 was the commonest pattern with an incidence of 30.3% followed by pattern 2. The site of origin of segmental arteries and their point of entry into the kidney were recorded and tabulated. The segmental arteries were classified into different types based on the frequency of their occurrence in decreasing order. In each of them, Type 1 is the commonest variant seen based on the origin of the apical artery (A), anterior upper segmental artery (AU), anterior middle segmental artery (AM), lower segmental artery (L), and posterior segmental artery (P). Conclusions The arrangement of hilar structures has been classified into six patterns and the variations existing in each of the segmental branches of the RA have been categorized as well. The knowledge will be invaluable for accurate radiographic interpretation of the renal vasculature and effective surgical planning in cases involving kidney transplantation, renal trauma, and partial nephrectomy. Furthermore, it will serve to prevent complications during surgical procedures.

Assessment of Body Fat Percentage Using B-Mode Ultrasound Technique versus Skinfold Caliper in Obese Healthy Volunteers.

Background and aims The measurement of the skinfold thickness at various sites with the calipers has remained the traditional method for estimation of body fat percentage (%BF) in clinical practice. Although this technique is relatively inexpensive and easy to learn, there are more chances of errors while measuring the skinfold thickness by this method. Therefore, no single standard prediction formula for the determination of body fat could be fixed. The aim of our study was to use B-mode ultrasound (US) for measuring the subcutaneous fat thickness and the calipers for skinfold thickness, and then compare, correlate, and derive the prediction equations for estimation of %BF by both the techniques. Methods This cross-sectional, observational, monocentric study was conducted on 43 Indian male volunteers aged 18 to 40 years. After collecting anthropometric data (age, height, weight, body mass index, waist circumference, hip circumference, waist-to-hip ratio [WHR], etc.), the skinfold thickness was measured at four standard sites (biceps, triceps, subscapular region, and suprailiac region) with skinfold caliper (SFC) and then B-mode US. The data were analyzed for distribution, and independent t-test was applied to compare the difference between two means of a %BF estimated by both the methods. The prediction equations were developed from anthropometric and skinfold thickness data obtained from both the methods, i.e., SFC and US, by applying stepwise multiple linear regression. Results It was observed that mean values of all the skinfold thicknesses along with the %BF measured by SFC were far more than those measured by US. The %BF measured by US technique (%BF US) was significantly lesser, i.e., 20.69 (SD: 3.126; p < 0.0002), than that of the SFC method (%BF SFC), i.e., 30.38 (SD: 4.634), which is 0.68 % higher. The best prediction equation for the %BF by SFC method was [%BF SFC = -26.154 + 0.208 SFss + 0.374 age + 0.354 SFbi + 32.066 WHR] (R2 = 84.8), where SFss and SFbi are skin fold thicknesses at subscapular and biceps regions, respectively, measured with SFCs, and that by the US method was [%BF US = 0.713 + 0.351 USsi + 0.232 age + 0.248 USss + 0.448 USbi] (R2 = 84.6), where USsi and USss are skinfold measurements at suprailiac and subscapular regions, respectively, measured by US technique. Conclusion In our study, we arrived to the conclusion that even though the estimated %BF by both the methods were found to have a significant correlation with each other, the values were very less in case of the US method. In the prediction equations, it was found that the skinfold thickness at the suprailiac region was not found to be the significant determining factor for estimation of %BF by SFC method as that by the US method. Looking at the lesser sample size with all participants being males, we do not recommend the prediction equations to be used in clinical practice in spite of the high R2 values.

Functional Connectivity of Prefrontal Cortex in Various Meditation Techniques - A Mini-Review.

Meditation is a practice of concentration and relaxation. In philosophical terms, it is a process of gaining self-consciousness. Although there is diversity in meditation (Mindfulness, compassion, transcendental, and focused attention meditation), interventions show that meditation practices improve prefrontal cortex (PFC) functions like cognition, self-awareness, attention, and memory and reduce psychological symptoms. These results are thought to be due to meditation increasing functional connections of different brain regions. We reviewed to show the functional connectivity of the prefrontal cortex in various meditation practices. We were viewed various neuroimaging interventions of functional connectivity associated with the prefrontal cortex and different brain areas during meditation techniques on healthy meditators compared with non-meditators. fMRI findings show that meditation practices are associated with increased neural function and processing, default mode network, gray matter volume, and functional coupling in the brain area related to different parts of PFC. PFC's functional connectivity is associated with increased attention, working memory, cognitive control, executive control, emotion regulation, counteracting adverse effects, self-perception, and self-compassion. Furthermore, PFC's functional connectivity decreases anxiety, depression, perceived stress, negative emotion, and hyperarousal symptoms. In this review, we outlined the published effect of meditation on the function and structure of the different parts of the prefrontal cortex. We suggest a positive theoretical correlation between meditation and the functional connectivity of the prefrontal cortex. Altered prefrontal connectivity is seen in some neurological and psychosocial disorders. Therefore meditation can also play an influential role in treating these disorders.

Terminal Condylar Facets of the Femur: Implications for Knee Arthroplasty.

In wake of changing lifestyle and increasing surgical expertise, knee replacement surgeries have become common. Attempts at improving the postoperative range of motion have prompted high-flexion knee arthroplasties. Consequently, there is a need to study the anatomy of knee joint in high flexion. This study focused on a holistic description of terminal condylar articular facet (TCAF; part of the femoral articular area in contact with the tibia in high flexion) of medial and lateral condyles and their quantification. In total, 104 dry femora and 16 dissected cadaveric knee joints (10 adult and 6 fetal) were studied. In most cases, the medial TCAF showed a tongue- or wedge-shaped extension in its lateral half, which has been referred to as extended condylar facet (ECF). The surface area of the ECF was approximately 0.5 cm2. In adult cadaveric dissections, the fibrous capsule showed the lax attachment beyond the ECF, thus creating a cave in the medial tibiofemoral compartment. These features were absent in fetal dissection. The presence of an ECF has not been documented in dry bones and has not been quantified. The variability of the size of this extension supports the hypothesis of this being an acquired trait. This study is expected to provide factual data for implant design improvement and a new anthropological data on Indian femora.

Anatomical Correlation of Core Muscle Activation in Different Yogic Postures.

Faulty postures due to sedentary lifestyle cause weakening of core muscles which contributes to increased incidence of musculoskeletal disorders (MSDs). Although a few research studies have quantified the core muscle activity in various yogic exercises used in rehabilitation programs, evidence correlating it to functional anatomy is scarce. Such information is important for exercise prescription when formulating treatment plans for MSDs. Therefore, the objective of this review article is to examine the literature and analyze the muscle activity produced across various yoga postures to determine which type of yoga posture elicits the highest activation for the core muscle in individuals. Literature search was performed using the following electronic databases: Cochrane Library, NCBI, PubMed, Google Scholar, EMBASE, and web of science. The search terms contained: Core muscle activation and yogic posture OR yoga and rehabilitation OR intervention AND Electromyography. Activation of specific core muscle involved asanas which depended on trunk and pelvic movements. Description of specific yogic exercise as they relate to core muscles activation is described. This information should help in planning yogic exercises that challenge the muscle groups without causing loads that may be detrimental to recovery and pain-free movement. Knowledge of activation of muscles in various yogic postures can assist health-care practitioners to make appropriate decisions for the designing of safe and effective evidence-based yoga intervention for MSDs.

Crista terminalis, musculi pectinati, and taenia sagittalis: anatomical observations and applied significance.

Background. The complex architecture of the right atrium, crista terminalis (CT), and the musculi pectinati (MP) poses enormous challenges in electrophysiology and cardiac conduction. Few studies have been undertaken to substantiate the gross features of MP, in relation to the CT, but there is still scarcity of data regarding this. We tried to reinvestigate the gross arrangement of muscle bundles in the right atrium. Methods. Utilizing 151 human hearts and orientation of MP and its variations and relationship to the CT were investigated along with taenia sagittalis (TS). Patterns of MP were grouped in 6 categories and TS under three groups. Result. A plethora of variations were observed. Analysis of all the specimen revealed that 68 samples (45%) were of type 1 category and 27 (18%) fell into type 2 category. Prominent muscular columns were reported in 12 samples (8%). 83 samples (55%) presented with a single trunk of TS. Multiple trunks of TS were reported in 38 samples (25%). Conclusion. Samples with type 6 MP and type B/type C TS, which have a more complex arrangement of fibers, have a tendency to be damaged during cardiac catheterization. Nonetheless, the area as a whole is extremely significant considering the pragmatic application during various cardiac interventions.