Association Between Foramen Rotundum and Trigeminal Neuralgia in the Saudi Population: A Radiological Study.

The trigeminal nerve is responsible for transmitting sensory information from the face, nasal and mouth cavities, and most of the scalp. Trigeminal neuralgia (TN) is a chronic facial pain disorder characterized by spontaneous paroxysmal pain throughout the distribution of the trigeminal nerve. This study investigated the morphological and morphometric variations of the foramen rotundum (FR) and its association with TN through a retrospective radiological analysis. A cohort of 97 participants from King Fahad University Hospital, Saudi Arabia, comprising 57 TN patients and 40 controls, underwent head CT scans for measurement and analysis. The study revealed significant differences in the FR morphology between TN patients and controls, particularly noting narrower FR measurements among TN individuals, especially in females. The right side demonstrated narrower FR dimensions, potentially correlating with the predominant side of pain in TN patients. While the presence of bony spurs was absent in all participants, variations in FR shape, size, and spatial positioning were observed and compared across genders and groups. These findings provide crucial insights into the potential anatomical factors contributing to TN, emphasizing the importance of understanding FR variations in clinical assessment and management of TN cases. Further research focusing on FR morphology and its clinical implications is recommended to enhance understanding and aid medical professionals in addressing TN-related concerns.

Morphometric Parameters of the Ear and Their Sexual Dimorphism in the Eastern Province of Saudi Arabia.

Background The human ear is a distinctive facial feature, revealing valuable information about ethnicity, gender, and age. Anthropometric measures play a crucial role in fields such as forensic medicine, prosthetics, and plastic surgery. The external ear, known for its diversity in structure and individual characteristics, has become a subject of interest in various populations. This study aims to determine the mean values of morphometric measurements for both right and left ears while exploring sexual dimorphism in ear dimensions. Methodology A prospective, observational, cross-sectional study was conducted among 200 volunteers from the eastern province of Saudi Arabia, comprising 98 males and 102 females, at the Department of Anatomy, Institute of Medical Sciences, Imam Abdulrahman Bin Faisal University. Participants were randomly selected from King Fahad University Hospital workers and patients. Using a Vernier caliper and after obtaining consent, various aspects of ear morphology were measured. The study employed statistical analyses such as the volunteers' t-test, Pearson's coefficient of correlation, and linear regression equations. Results In males, the mean total height of the right and left ears was 6.054 ± 0.5394 and 6.044 ± 0.5235 cm, respectively, while for females, it was 5.489 ± 0.4481 and 5.763 ± 4.8446 cm, respectively. The mean widths, heights, and other dimensions of the ears exhibited variations between genders. Conclusions The study provides comprehensive insights into the dimensions and indices of the pinna among the population of the eastern province of Saudi Arabia. The findings confirmed the presence of sexual dimorphism in the ear measurements, consistent with observations in other ethnic groups.

Morphological variations and morphometry details of the foramen ovale in the Saudi population: a retrospective radiological study.

The foramen ovale is one of the essential foramina in the middle cranial fossa, more precisely, in the superior surface of the greater wing of the sphenoid bone. It has essential surgical and diagnostic significance since it serves as a surgical landmark, and crucial neurovascular vessels such as the mandibular nerve and accessory meningeal artery pass through it. Therefore, understanding the morphological and morphometric variations of the foramen ovale is essential for accurately identifying, diagnosing, and managing related pathologies. The study aimed to evaluate the morphological variations and morphometric details of the foramen ovale in the Saudi population. A radiological study was conducted to observe the measurements and the shapes of the foramen ovale in the skull with its anatomical variants. Retrospective data was collected from the Department of Radiology, King Fahad University Hospital, Saudi Arabia. The sample consisted of 100 human skulls from computed tomography scans, including 50 males and 50 females. The values for the mean length, width, and distance from the midline on the right side were 6.462 mm ± 1.681 mm, 4.897 ± 1.0631 mm, and 2.4565 ± 0.51275 mm, and 6.451 ± 1.6691 mm, 4.812 ± 1.0848 mm and 2.4290 ± 0.60039 mm for the left side, respectively. The foramen shape was oval in the majority (47%), followed by round shape (31%) with no bony outgrowths such as spur in the studied foramina. Furthermore, the morphometric variation between males and females was statistically insignificant (p-value>0.05). The observed variation of foramen ovale in this study has significant anatomical and clinical applications for various diagnostic and surgical procedures.

The MRI of Lumbar Vertebral Canal in Low Back Pain: A Cross-Sectional Study.

Background The imaging of the lumbar canal is an important aspect of low back pain (LBP) management. Magnetic resonance imaging (MRI) has gained widespread acceptance for the evaluation of spine anatomy. Objective The objective of the study is to compare the MRI findings of the anteroposterior diameter, transverse diameter, and thecal sac area of the lumbar vertebral canal in symptomatic low back pain patients to that of patients without low back pain. Methods The cross-sectional study included 200 subjects of which 100 subjects (49 males and 51 females) were symptomatic cases of low back pain and 100 subjects (53 males and 47 females) had no symptoms of low back pain and were enrolled as controls. The MRI scans were studied for the anteroposterior diameter, transverse diameter, and thecal sac area of the lumbar vertebral canal. Results In our study, the anteroposterior diameter of the lumbar vertebral canal among cases was found to have a mean of 14.42, 14.09, 13.44, 13.63, and 13.79 with a standard deviation (SD) of 1.25, 1.32, 1.75, 1.75, and 2.65 at L1, L2, L3, L4, and L5 levels, respectively. The anteroposterior diameter of the lumbar vertebral canal among controls was found to have a mean of 15.26, 15.16, 14.71, 14.68, and 15.28 with an SD of 1.60, 1.67, 1.30, 1.36, and 1.97 at L1, L2, L3, L4, and L5 levels, respectively. The difference in anteroposterior diameters of the lumbar vertebral canal was found to be statistically significant at each level, between cases and controls. The transverse diameter of the vertebral canal was found to be smaller in cases as compared to controls with a statistically significant difference at each of the levels studied. The thecal sac area of the vertebral canal was found to be less in subjects with low back pain at each of the vertebral levels studied. Conclusion The study results provide insight into the lumbar vertebral parameters in the study population and give comparative data among the symptomatic low back pain patients and control subjects without low back pain. The MRI reflected decreased anteroposterior diameter, transverse diameter, and thecal sac area of the lumbar vertebral canal among symptomatic low back pain patients.

Morphometry of Conus Medullaris in the Saudi Population and Its Clinical Importance.

Objective The objective of this article is to evaluate the morphometry and termination of conus medullaris (CM) in the eastern province of Saudi Arabia. Methodology The lumbar spine magnetic resonance imaging (MRI) scans of 179 citizens of Saudi Arabia were selected and divided into males and females. Parameters such as the level of termination of CM, the length/width of CM, and its termination were reported. Results The maximum number of males and females were observed in the less than 20 years age group as 23 (25.5%) and 22 (24.7%), respectively. The termination level of CM was at the (first lumbar vertebra) L1 vertebra in 51.4% of the Saudi population. The level of termination of CM is below the (second lumbar vertebra) L2 level in one patient at L3, L3-L4, L5, and L5-S1 levels. On comparing the length of CM, no statistically significant difference was observed between the different levels of the vertebra. However, there was a statistically significant difference between the width and the CM termination (p=0.02). The various age groups and CM termination had no statistically significant correlation (p=0.47). Conclusion The most common level of termination of conus medullaris was at the L1 vertebra. The level of CM termination is strongly associated with the width of CM.

Comparative Study of Hypo-Fractionated Radiotherapy Versus Conventional Radiotherapy in Breast Cancer.

BACKGROUND: Breast cancer is the most commonly diagnosed cancer causing death among females worldwide. Radiotherapy after lumpectomy/mastectomy in breast cancer cases is a successful treatment modality taking five weeks to complete. The aim of the present study is to compare the effectiveness of hypo-fractionated radiotherapy in breast cancer patients with conventional radiotherapy with respect to outcome and toxicity. METHODS: Sixty patients were randomly divided equally into a conventional group, Group A (dose: 50 Gy in 25 fractions), and a hypo-fractionated short-course radiotherapy group, Group B (dose: 40 Gy in 16 fractions). After thorough clinical and laboratory examination of all patients, the disease status was assessed prior to radiotherapy and three and six months after completion of radiotherapy. The cardiopulmonary function was assessed using echocardiography and pulmonary function tests prior to the procedure. The assessment of the development of toxicity (dysphagia, skin, lung, and lymphedema) was done during every clinical visit. RESULTS: The mean age of patients was 53.28 ± 9.73 years in Group A, and 55.67 ± 10.41 years in Group B (p=0.82). The right breast was involved in 13 (43.4%) patients in Group A and 14 (46.6%) in Group B, and the left breast was involved n 17 (56.6%) patients in Group A and 16 (53.4%) in Group B (p=0.81). Most of the patients were post-menopausal; 24 (80%) in Group A and 25 (83.4%) in Group B (p=0.91). Eleven (36.6%) patients were of stage T2N1M0 in both groups. However, no statistical difference was observed between the groups in the TNM (tumor, node, and metastasis) staging using the AJCC (American Joint Committee on Cancer) criteria (p=0.26). On comparing the responses in Group A and Group B, no significant difference was observed in either of the groups from immediate post-treatment to the 12-month follow-up period (p=0.53 and p=0.64, respectively). CONCLUSION: Hypo-fractionated radiotherapy is as effective as conventional radiotherapy and can be used as an alternative method for treatment following breast cancer surgery.

A Comparative Study on Clinical Evaluation of the Hypolipidemic Effects of Allium sativum, Trigonella foenum-graecum, Commiphora mukul, Picrorhiza kurroa, and Piper nigrum: A Pilot Study.

Background Cardiovascular disease is a leading cause of morbidity and mortality. Therefore, it is essential to prevent cardiovascular diseases by correcting modifiable risk factors such as lowering lipid levels, lowering blood pressure, improving eating habits, giving up smoking, etc. The present study assessed the efficacy of herbal preparation containing Allium sativum (A. sativum), Commiphora mukul (C. mukul), and Trigonella foenum-graecum (T. foenum-graecum) in patients with hyperlipidemia. Methodology Patients were given extracts of A. sativum 350 mg, T. foenum-graecum 350 mg, C. mukul 200 mg, Picrorhiza kurroa (P. kurroa) 200 mg, and Piper nigrum (P. nigrum) 5 mg. Unichem Laboratories, Mumbai, provided placebo tablets similar in shape and size to herbal tablets. Patients were assessed for compliance, and a complete lipid profile was done at DO, D15, D46, D76, and D106. In addition, total cholesterol and high-density lipoprotein-cholesterol (HDL-C) serum triglyceride were estimated by the respective methods throughout the study. Results The weight of the patients remained stable, the mean weight before being 65.42 ± 8.35 kg and after completion of the study being 65.42 ± 8.35 kg. There were no changes in the ECG during or after the drug therapy in any of the patients. Group A comprised nine patients, and group B had ten patients. Serum creatinine (mg %) was 0.94 and 0.95, fasting blood sugar mg (%) was 111.05 and 99.63, and postprandial blood sugar (mg %) was 150.89 and 147.94 on pre-treatment and post-treatment, respectively. The mean serum triglyceride levels in group A were 271.11, 261.11, 293.89, 167.22, and 128.89, and serum HDL- C levels were 46.11, 46.11, 54.44, 52.22, and 54.44. Serum triglyceride levels in group B were 268, 268.5, 202, 171, and 116, and serum HDL- C levels were 48.5, 48, 50, 50, and 53.5 on day 0, 15, 46, 76, and 106, respectively. A significant reduction in total cholesterol levels was observed on D46, D76, and D106, with a maximum reduction on D76 (25.36%). Similarly, a reduction in serum triglyceride was also observed on D46, D76, and D106, with a maximum reduction on D106 (52.02%). A significant difference was observed (P <0.05). There was also a significant reduction of low-density lipoprotein cholesterol (LDL-C) on D46, D76, and D106, with the maximum reduction on D76 (28.79%). There was a significant rise of HDL-C on D46 and D106, with a maximum rise on D106 (15.41%). A significant difference was observed (P <0.05). Conclusion The study drugs are safe and efficacious in reducing the total cholesterol, serum triglycerides, LDL-C levels, and increasing HDL-C levels.

Impact of khat leaves on glycosylated haemoglobin and lipid profile in healthy individuals in Dire Dawa, Ethiopia.

Objective: The objective of this study is to determine the effect of Catha edulis leaves on glycosylated haemoglobin and lipid profiles in healthy individuals in Dire Dawa, Ethiopia. Method: A cross-sectional study was conducted to evaluate the effect of khat leaves on the glycated haemoglobin and lipid profile in the Dire Dawa population. For the study, 100 male subjects (aged ⩾20-⩽40 years) were recruited and divided into two groups, each consisting of 50 subjects: the first group was khat chewing people while the other group was non-khat chewing individuals. Blood samples were collected and tested to evaluate the glycated haemoglobin and lipid profiles. Results: The mean glycated haemoglobin value of khat chewers was 5.33% and for non-chewers, it was 5.48%, respectively. Since p value is less than the significance value, the t-test supports the reduction in glycated haemoglobin values in khat chewers. The mean values of total cholesterol, and triglycerides in khat chewers are 175.2 and 172.92, and for non-chewers they are 168.7 and 164.56, respectively. Conclusion: From this study, we concluded that Catha edulis leaves have a significant effect on glycosylated haemoglobin levels. Mean glycated haemoglobin values of long-term healthy khat chewers are comparatively less than healthy non-chewers. Long-term khat chewing increases total cholesterol levels and triglycerides levels but there is no significant effect on the high-density lipoprotein and low-density lipoprotein levels.

Defining the Components of the Deltoid Ligament (DL): A Cadaveric Study.

BACKGROUND: The deltoid ligament (DL) is a strong triangle-shaped ligament with a complex fascicular arrangement. Understanding the morphological and/or functional typing of the DL structure is hindered by a paucity of clear, quantitative, and reproducible data and is further complicated by inconsistent terminology use. The aim of this work was to describe different components of the DL using strict identification criteria. METHODS: Thirty embalmed cadaveric ankles of both sides were dissected on all sides and studied by using gross examination, micro-dissection, and light microscopy by tracing the fascicular pattern of each under 6X magnification. RESULTS: Six ligamentous bands were identified. The tibiotalocalcaneal ligament (TTC) and the superficial posterior tibiotalar ligament (sPTT) were two superficial variants and the anterior tibiotalar ligament (ATT), the anterior tibiotalonavicular ligament (ATTN), the intermediate tibiotalar ligament (ITT), and the deep posterior tibiotalar ligament (dPTT) were four deep variants. The TTC was identified in all 30 embalmed cadaveric specimens. Five additional ligamentous bands (ITT, sPTT, dPTT, ATT, and ATTN) were variable findings in the current cohort. CONCLUSION: This study presents six ligamentous bands as a regular finding and five additional ligamentous bands as variable findings in the dissected specimen. This data could assist in the radiological diagnosis of DL injuries and advanced procedures related to its surgical repair and reconstruction.

Sexual dimorphic parameters of femur: a clinical guide in orthopedics and forensic studies.

Sexual dimorphic studies of various parameters of the femur play an important role in forensic studies. Various femur morphometric parameters help estimate an individual's age, sex, and stature from unknown skeletal remains. This research was done to analyze maximum length, trochanteric oblique length, and diameter of the femur head for sexual dimorphism. The study was done on 200 (128 male & 72 female) Indian adult human femora, which were fully ossified, dry, and free from deformity. The maximum length of the femur (L), trochanteric oblique length (TOL), and vertical diameter of the head (VDH) were measured using an osteometric board and digital Vernier calipers. The mean length of the femur was 436.88 mm in males and 402.38 mm in females, respectively. The mean trochanteric oblique length of the femur was 423.78 mm in males and 387.18 mm in females, respectively. The mean vertical diameter of the femur head was 43 mm in males and 38.19 mm in females, respectively. Depending upon the results of this study, it was concluded that the mean values of maximum length, trochanteric oblique length, and vertical diameter of the femur head are significantly higher in males than females. These parameters are useful and reliable for sexual dimorphism in anthropometric and forensic studies, especially in identifying skeletal remains. These differences can also be considered in selecting or designing the exact ranges of the gender-specific prosthesis for Orthopedic surgeries.